Highlights from the new 2023 ICD-10-CM codes
Dementia, endometriosis, maternal care for fetal disorders, head injuries, and motorcycles/electric bike accidents are among the major changes in the staggering 1176 new billable codes for 2023 (last year’s numbers only topping out at 159 new billable codes). 251 codes have also been deleted, several terms and inclusion terms have been modified, and 36 codes are being converted to parent codes.
Social determinants of health ICD-10 codes
New social determinants of health codes have been introduced in Chapter 21: Factors influencing health status and contact with health services (Z00-Z99) adding several new codes including ‘Z59.82 Transportation insecurity,’ and ‘Z59.87 Material hardship’.
Dementia ICD-10 codes
With dementia becoming a growing health concern due to an aging baby boomer generation, Chapter 5: Mental, Behavioral and Neurodevelopmental Disorders expands dementia families 3-fold with the addition of 87 new codes. It appears that CMS wants more detailed information on dementia severity and associated behavioral disorders, likely to support improvements in clinical care and to identify levels of expenditure. The 2023 ICD-10-CM official guidelines (page 43) read:
“The ICD-10-CM classifies dementia (categories F01, F02, and F03) on the basis of the etiology and severity (unspecified, mild, moderate or severe). Selection of the appropriate severity level requires the provider’s clinical judgment and codes should be assigned only on the basis of provider documentation (as defined in the Official Guidelines for Coding and Reporting), unless otherwise instructed by the classification. If the documentation does not provide information about the severity of the dementia, assign the appropriate code for unspecified severity.If a patient is admitted to an inpatient acute care hospital or other inpatient facility setting with dementia at one severity level and it progresses to a higher severity level, assign one code for the highest severity level reported during the stay.”
These new dementia codes were discussed during the ‘ICD-10-CM Coordination and Maintenance Committee’ 2021 meetings in both March and September. The proposal stated: “Although codes exist for dementia without and with behavioral disturbances, there is a need for additional detail on other key associated disorders, particularly psychotic disorders, mood disorders, and anxiety.”