The 2024 ICD-10-CM coding updates, which will bring significant changes, are set to take effect on October 1, 2023. It is important for home health agencies and their coders to thoroughly understand the changes and address their impact on coding processes.
Below are some notable changes we think have significant impact on home health coding:
Chapter 6: Diseases of the Nervous System (G00-G99)
The final update confirms the introduction of five new codes for Parkinson’s disease:
- G20.A1 (Parkinson’s disease without dyskinesia, without mention of fluctuations).
- G20.A2 (Parkinson’s disease without dyskinesia, with fluctuations).
- G20.B1 (Parkinson’s disease with dyskinesia, without mention of fluctuations).
- G20.B2 (Parkinson’s disease with dyskinesia, with fluctuations).
- G20.C (Parkinsonism, unspecified).
Chapter 13: Diseases of the Musculoskeletal System and Connective Tissue (M00-M99)
This contains 42 new codes to help further define osteoporosis with pathological fracture. Some examples:
- M80.8B2P (Other osteoporosis with current pathological fracture, left pelvis, subsequent encounter for fracture with malunion)
- M80.8B9D (Other osteoporosis with current pathological fracture, unspecified pelvis, subsequent encounter for fracture with routine healing)
- M80.0B1K (Age-related osteoporosis with current pathological fracture, right pelvis, subsequent encounter for fracture with nonunion)
- M80.0B2G (Age-related osteoporosis with current pathological fracture, left pelvis, subsequent encounter for fracture with delayed healing)
The addition of osteoporosis with current pathological fractures of the pelvis is something that has been lacking in the code set and will help provide greater specificity on the fracture location.
Chapter 21: Factors Influencing health status and contact with Health Services (Z00-Z99)
The update contains several changes that impact Social Determinants of Health (SDoH). Here’s a concise overview:
- Introduction of new code Z29.81 for HIV pre-exposure prophylaxis encounters
- A ‘code also’ note for reporting HIV risk factors, when applicable, using codes such as Z20.6 (Contact with and [suspected] exposure to human immunodeficiency virus [HIV]) and Z72.5– (High risk sexual behavior).
- Extensive ‘code also’ update for Z62.8 (Other specified problems related to upbringing) adds the following to the list of codes that should also be reported when applicable:
- Z63.3- (Absence of a family member)
- Z63.4 (Disappearance and death of family member)
- Z63.5 (Disruption of family by separation and divorce)
- Z63.8 (Other specified problems related to primary support group)
- Z63.7- (Other stressful life events affecting family and household)
- Introduction of new code Z91.85 (Personal history of military service) as an ‘Excludes2’ code for Z91.82 (Personal history of military deployment).
- Z91.85 also has the clarification of terms “personal history of serving in the armed forces” and “personal history of veteran”.
Keeping Up with the Updates to Ensure Coding Accuracy
It is crucial for coders working with home health agencies to learn to effectively use these coding updates. Ensuring coders are knowledgeable about the new codes, as well as changes in reporting requirements for conditions is essential for accurate billing processes and maintaining compliance. By getting on top of these changes now, home health agencies can maintain coding accuracy while promoting patient-centric care.
Moreover, agencies should be proactive in educating their referral sources on the upcoming changes. This will give providers an opportunity to start proactively documenting greater specificity to help decrease queries once the updates take effect in October