2024 ICD-10 Diagnosis Changes, Part II

September 25, 2023

In last week’s Coffee & Coding, we highlighted two sections of the new ICD-10 codes coming on October 1, which provided an indication of just how extensive the additions are. There were 24 changes to codes for diseases of the nervous system, plus revisions with Excludes 1 and Excludes 2. The additions also expanded the codes for Parkinson’s disease and the connection with dyskinesia and implemented new codes for migraines and epilepsy to address myoclonus epilepsy and refractory migraines. And those were just the changes to Chapter 6. For Chapter 7, covering diseases of the eye and adnexa, we saw new codes added for retinal disorders, other strabismus, visual disturbances and foreign body sensations.

Now let’s take a look at the next three sections of the nearly 400 new codes you’ll need to be prepared to use. Here is a brief overview:

  • CMS added 36 new codes to the diseases of the musculoskeletal system and connective tissue (M00-M99) chapter.
  • 22 new codes were added, and six were revised in the congenital malformations, deformations, and chromosomal abnormalities (Q00-Q99) chapter.
  • 30 new codes were added, and six were invalidated from the factors influencing health status and contact with health services (Z00-Z99) chapter.

New codes for diseases of the musculoskeletal system and connective tissue:

M32 Systemic lupus erythematosus (SLE)
M32.19 Other organ or system involvement in systemic lupus erythematosus

Use Additional code(s) to identify organ or system involvement, such as encephalitis (G05.3)

M34 Systemic sclerosis [scleroderma]
M34.2 Systemic sclerosis induced by drug and chemical

Code first Revised to poisoning due to drug or toxin, if applicable (T36-T65 with fifth or sixth character 1-4)

M36 Systemic disorders of connective tissue in diseases classified elsewhere
M36.8 Systemic disorders of connective tissue in other diseases classified elsewhere

Code first alkaptonuria (E70.29)

ochronosis (E70.29)

M41 Scoliosis

Excludes2: postprocedural scoliosis (M96.89)

postradiation scoliosis (M96.5)

M41.1 Juvenile and adolescent idiopathic scoliosis
M41.12 Adolescent idiopathic Scoliosis
M63 Disorders of muscle in diseases classified elsewhere

Code first neoplasm (C49.-, C79.89, D21.-, D48.1-)

Disorders of bone density and structure (M80-M85)

M80 Osteoporosis with current pathological fracture
M80.0 Age-related osteoporosis with current pathological fracture
M80.0B Age-related osteoporosis with current pathological fracture, right pelvis
M80.0B1 Age-related osteoporosis with current pathological fracture, left pelvis Other
M80.0B2 Age-related osteoporosis with current pathological fracture, left pelvis
M80.0B9 Age-related osteoporosis with current pathological fracture, unspecified pelvis
M80.8 Other osteoporosis with current pathological fracture
M80.8B Other osteoporosis with current pathological fracture, pelvis
M80.8B1 Other osteoporosis with current pathological fracture, right pelvis
M80.8B2 Other osteoporosis with current pathological fracture, left pelvis
M80.8B9 Other osteoporosis with current pathological fracture, unspecified pelvis
M83 Adult osteomalacia

Excludes1: vitamin D-resistant osteomalacia (E83.31)

vitamin D-resistant rickets (active) (E83.31)

Other osteopathies (M86-M90)

M89 Other disorders of bone
M89.7 Major osseous defect

Code first osteolysis (M89.5-)

M90 Osteopathies in diseases classified elsewhere
M90.8 Osteopathy in diseases classified elsewhere

Code first vitamin-D-resistant rickets (E83.31)

Periprosthetic fracture around internal prosthetic joint (M97)

M97 Periprosthetic fracture around internal prosthetic joint

Code first, if known, the specific type and cause of fracture, such as traumatic or pathological

New codes for congenital malformations, deformations, and chromosomal abnormalities:

Congenital malformations of the circulatory system (Q20-Q28)

Q21 Congenital malformations of cardiac septa
Q21.1 Atrial septal defect

Excludes2: ostium primum atrial septal defect (type I) (Q21.20)

Other congenital malformations of the digestive system (Q38-Q45)

Q44 Congenital malformations of gallbladder, bile ducts and liver
Q44.7 Other congenital malformations of liver

Code also, if applicable, associated malformations affecting other systems

Q44.70 Other congenital malformation of liver, unspecified

Add Congenital malformation of liver, NOS

Q44.71 Alagille syndrome Add Alagille-Watson syndrome
Q44.79 Other congenital malformations of liver

Accessory liver

Congenital absence of liver

Congenital hepatomegaly

Congenital malformations and deformations of the musculoskeletal system (Q65-Q79)

Q67 Congenital musculoskeletal deformities of head, face, spine, and chest
Q67.2 Dolichocephaly

Excludes1: sagittal craniosynostosis (Q75.01)

Q67.3 Plagiocephaly

Excludes1: coronal craniosynostosis (Q75.02-)

lambdoid craniosynostosis (Q75.04-)

Q75 Other congenital malformations of skull and face bones
Q75 Other congenital malformations of skull and face bones
Q75.0 Craniosynostosis
Q75.00 Craniosynostosis unspecified

Craniosynostosis NOS

Q75.001 Craniosynostosis unspecified, unilateral
Q75.002 Craniosynostosis unspecified, bilateral
Q75.009 Craniosynostosis unspecified Add Imperfect fusion of skull
Q75.01 Sagittal craniosynostosis

Non-deformational dolichocephaly

Non-deformational scaphocephaly

Excludes1: plagiocephaly (Q67.3)

Q75.02 Coronal craniosynostosis

Non-deformational anterior plagiocephaly

Excludes1: dolichocephaly (Q67.2)

Q75.021 Coronal craniosynostosis unilateral

Non-deformational anterior plagiocephaly

Q75.022 Coronal craniosynostosis bilateral

Non-deformational brachycephaly

Q75.029 Coronal craniosynostosis unspecified
Q75.03 Metopic craniosynostosis

Trigonocephaly

Q75.04 Lambdoid craniosynostosis

Non-deformational posterior plagiocephaly

Excludes1: dolichocephaly (Q67.2)

Q75.041 Lambdoid craniosynostosis, unilateral
Q75.042 Lambdoid craniosynostosis, bilateral
Q75.049 Lambdoid craniosynostosis, unspecified
Q75.05 Multi-suture craniosynostosis
Q75.051 Cloverleaf skull Add Kleeblattschaedel skull
Q75.052 Pansynostosis
Q75.058 Other multi-suture craniosynostosis

Excludes1: coronal craniosynostosis, bilateral (Q75.022)

lambdoid craniosynostosis, bilateral (Q75.042)

Q75.08 Other single-suture craniosynostosis

Other congenital malformations (Q80-Q89)

Q84 Other congenital malformations of integument
Q84.1 Congenital morphological disturbances of hair, not elsewhere classified

Excludes1:  Revise to Menkes’ kinky hair syndrome (E83.09)

Q85 Phakomatoses, not elsewhere classified
Q85.8 Other phakomatoses, not elsewhere classified
Q85.81 PTEN hamartoma tumor syndrome
Q87 Other specified congenital malformation syndromes affecting multiple systems
Q87.4 Marfan syndrome
Q87.40 Marfan syndrome, unspecified
Q87.41 Marfan syndrome with cardiovascular manifestations
Q87.410 Marfan syndrome with aortic dilation
Q87.418 Marfan syndrome with other cardiovascular manifestations
Q87.42 Marfan syndrome with ocular manifestations
Q87.43 Marfan syndrome with skeletal manifestation
Q87.8 Other specified congenital malformation syndromes, not elsewhere classified
Q87.83 Bardet-Biedl syndrome
Q87.84 Laurence-Moon syndrome
Q87.85 MED13L syndrome

Asadollahi-Rauch syndrome

Mediator complex subunit 13L syndrome

Code also, if applicable, any associated manifestations such as:

  • autism spectrum disorder
  • (F84.0-)congenital malformations of cardiac septa (Q21-)
  • epilepsy and recurrent seizures (G40.-)
  • intellectual disability (F70-F79)
Q87.89 Other specified congenital malformation syndromes, not elsewhere classified

Chromosomal abnormalities, not elsewhere classified (Q90-Q99)

Q90 Down syndrome

Code also associated physical condition(s), such as atrioventricular septal defect(Q21.2-)

Use Additional code(s) to identify any associated degree of intellectual disabilities (F70-F79)

Q93 Monosomies and deletions from the autosomes, not elsewhere classified
Q93.5 Other deletions of part of a chromosome
Q93.52 Phelan-McDermid syndrome

22q13.3 deletion syndrome

Use Additional code(s) to identify any associated conditions, such as:

  • autism spectrum disorder (F84.0)
  • degree of intellectual disabilities (F70-F79)
  • epilepsy and recurrent seizures (G40.-)
  • lymphedema (I89.0)

New codes for Social Determinants of Health (SDOH):

 

Z02.8 Encounter for other administrative examinations
Z02.84 Encounter for child welfare exam

Encounter for child welfare screening exam

Excludes2: encounter for examination and observation for alleged child physical abuse (Z04.72)

encounter for examination and observation for alleged child rape (Z04.42)

Z05.8 Observation and evaluation of newborn for other specified suspected condition ruled out
Z05.81 Observation and evaluation of newborn for suspected condition related to home physiologic monitoring device ruled out

Encounter for observation of newborn for apnea alarm without findings

Encounter for observation of newborn for bradycardia alarm without findings

Encounter for observation of newborn for malfunction of home cardiorespiratory monitor

Encounter for observation of newborn for non-specific findings home physiologic monitoring device

Encounter for observation of newborn for pulse oximeter alarm without findings

Excludes1: encounter for observation for suspected conditions related to home physiologic monitoring device ruled out (Z03.83)

neonatal bradycardia (P29.12)

other newborn apnea (P28.4-)

primary sleep apnea of newborn (P28.3-)

Z05.89 Observation and evaluation of newborn for other specified suspected condition ruled out
Z16.1 Resistance to beta lactam antibiotics
Z16.13 Resistance to carbapenem
Z22.3 Carrier of other specified bacterial diseases
Z22.34 Carrier of Acinetobacter baumannii
Z22.340 Carrier of carbapenem-resistant Acinetobacter baumannii
Z22.341 Carrier of carbapenem-sensitive Acinetobacter baumannii
Z22.349 Carrier of Acinetobacter baumannii, unspecified

 

Source:ftp.cdc.gov – /pub/Health_Statistics/NCHS/Publications/ICD10CM/2024/

Got a question about E/M coding? We’d love to hear from you.

Submit your questions by emailing us at coders@calmwatersai.com

 

 

Download PDF

Michelle Sergei-Casiano
Michelle Sergei-Casiano
Michelle Sergei-Casiano

CPC, CFPC, CEMC
Senior Manager, Regulatory and Coding Compliance
coders@calmwatersai.com

 

More Coffee & Coding

What, precisely, is a “self-limited” condition?

What, precisely, is a “self-limited” condition? May 6, 2024 This issue is a continuing source of uncertainty for coders and providers alike, especially since we all analyze and apply information differently in medical decision making (MDM). So, how can we bring...

More E/M Coding Questions (and Answers!)

More E/M Coding Questions (and Answers!) April 29, 2024 This week, we pick up where we left off with the last issue of Coffee & Coding, when we addressed questions about how tests and lab work can count toward complexity of data in medical decision-making (MDM).1...

When Can the Amount and Complexity of Data Apply to Lab Tests?

When Can the Amount and Complexity of Data Apply to Lab Tests? April 22, 2024 It’s a great question—and one that generates discussions in almost every medical office. In this issue (and next week’s, too), we’ll examine some scenarios that will help you clarify the...

More Pro Tips & Tricks

More Pro Tips & Tricks April 15, 2024 Back by popular demand: We received such a positive response to our “tips and tricks” edition of Coffee & Coding that we’ve decided to make it a recurring feature each quarter. So, we invite you to grab a fresh cup of...

The Problem with Independent Historians

The Problem with Independent Historians April 8, 2024 In most cases, we know who independent historians are: mothers, fathers, guardians, grandparents, or adult children. But we still see many instances when the term is incorrectly applied in the documentation—mostly,...

Making Complexity of Problems a Little Less Complex

Making Complexity of Problems a Little Less Complex April 1, 2024 We see a lot of questions (and confusion) over what constitutes an “acute illness with systemic symptoms.” In fact, according to the American Academy of Pediatrics, “Of the three elements that make up...

Making the Right Choice Between Level 3 and Level 4: Part Two

Making the Right Choice Between Level 3 and Level 4: Part Two March 25, 2024 In last week’s Coffee & Coding, we provided a refresher on key points to remember about coding appropriately for Level 3. This week let’s do the same for Level 4. Level 4 can be a little...

Level 3 or Level 4: Getting It Right

Level 3 or Level 4: Getting It Right March 18, 2024 Guidelines notwithstanding, deciding whether to apply Level 3 or Level 4 to a patient encounter isn’t always easy. In fact, we see a lot of inconsistency and confusion on this point. While many clinicians accurately...

Ending Confusion over Modifier 25

Ending Confusion over Modifier 25 March 11, 2024 It’s a big week here in Boston (my hometown). Sunday, of course, is St. Patrick’s Day. Here in Boston, we also remember March 17 as Evacuation Day—marking the anniversary of the British army leaving the city in 1776....

MDM Level 5: A Quick Refresher on a Complex Subject

MDM Level 5: A Quick Refresher on a Complex Subject March 4, 2024 We continue to see that, across all medical specialties, physicians are still nervous about billing for Level 5 office visits. I consistently find that many (if not most) providers code for Level 4 even...

HIPAA Compliance: Make sure you know ALL the rules

HIPAA Compliance: Make sure you know ALL the rules February 26, 2024 The Health Insurance Portability and Accountability Act (HIPAA) of 1996 is a federal law restricting access to individuals' private medical information. That much, I’m sure, our readers already knew....

Making sense of the new coding-by-time rules for 2024

Making sense of the new coding-by-time rules for 2024 February 19, 2024 We all know that the new year brings changes (some years, more than others). As it turns out, no sooner had we gotten clinicians on track with how much time belongs to the E/M CPT code set than...

How do you code a broken heart?

How do you code a broken heart? Plus: We answer your questions about toxicity monitoring. February 12, 2024 First things first: While remembering to apply the proper codes and include sufficient documentation, providers and coders must not lose sight of one essential...

Documentation Tips and Tricks: How to Avoid Common Mistakes

Documentation Tips and Tricks: How to Avoid Common Mistakes February 5, 2024 Every day we see coding mistakes that affect the accuracy of E/M coding levels. Some of them can be costly. So, in this issue of Coffee & Coding, we’ll look more closely at some of these...

Toxic diagnosis coding: What you may be missing

Toxic diagnosis coding: What you may be missing January 29, 2024 Three quick questions: When did you last look in that little section towards the back of your ICD-10 coding book called the Drug Table? How often have you coded an adverse reaction to a bug bite as...

Subscribe to Our Weekly Coffee & Coding Newsletter