Preparing for the 2024 ICD-10-CM Code Updates

In June, the Centers for Medicare and Medicaid (CMS) released the second ICD-10 update for financial year (FY) 2024. The update, which goes into effect on October 1, 2023, includes new codes, deleted codes, and revised codes for both ICD-10-CM (diagnosis coding) and ICD-10-PCS (procedural coding).

For revenue cycle staff, it is crucial to assess these changes before October 1st. Supporting coding staff with training and educational resources around the upcoming ICD-10 update can help reduce the risk of coding and modifier errors, which were the third and fourth most common drivers of denied claims according to a 2022 report by Experian Health. The downstream effect is improved compliance and less lost revenue caused by claims denials.

This article provides a high-level overview of some key updates to ICD-10-CM coding specifically, with commentary provided by Nym’s internal coding and compliance team. This is not a comprehensive review of all ICD-10-CM code updates.

Highlights from the ICD-10-CM FY2024 Update

The ICD-10-CM code set is designed for classifying and coding diagnoses and is used across various healthcare settings, including outpatient facilities, physician offices, and clinics. The FY2024 update includes 395 new codes, 13 code revisions, and 25 deleted codes spread across 21 different chapters.

In terms of new codes, there are a few chapters with significant updates come October 1, 2023.

Chapter 20: External Cause of Morbidity

There are 123 new codes being added to Chapter 20 in the FY2024 update, making up almost half of all newly added codes in this update. These codes mainly capture details around accidents and injuries, with many of the new codes being related to objects entering the body such as:

From the Nym coding team:

• While there may not be any Federal requirements for External Cause Codes, these codes can be significant in creating updates to State Government reporting systems. For example, the state of New York has reporting requirements associated with SPARCS, a comprehensive all-payer data reporting system established in 1979 as a result of cooperation between the healthcare industry and the government. This system specifically asks for external cause data in the form of the ICD-10-CM codes associated with this chapter. Get more details about SPARCS here.

Chapter 13: Diseases of the Musculoskeletal System and Connective Tissue

There are 36 new codes being added to Chapter 13 in the FY2024 update. Many of the new codes help further define osteoporosis with pathological fracture, such as:

From the Nym coding team:

• It will be important to look out for any updated medical necessity policies related to newly added codes in this chapter. For example, we can anticipate updates to medical necessity policies for things like dual x-ray absorptiometry (DEXA) scans. This is key to know, as osteoporosis is an ICD-10-CM code that typically supports the medical necessity of scans such as DEXA.

Chapter 21: Factors Influencing Health Status and Contact with Health Services

There are 30 new codes being added to Chapter 21 in the FY2024 update. Many of the new codes are related to social determinants of health (SDoH), specifically child upbringing, such as:

From the Nym coding team:

• SDOH that increase the complexity of medical decision-making for professional evaluation and management levels are now regularly part of the audit process. With the 2024 update, we have more SDOH ICD codes related to childhood custody, as seen above. 

There are also newly added codes for oncology that will enable oncologists to reflect a patient’s family history of polyps with the new family history codes, such as:

Leveraging technology to reduce the risks associated with coding updates

There are a significant number of ICD-10-CM coding updates going into effect on October 1st. For revenue cycle leaders and medical coders, preparing for updates like these is a time and resource-intensive process that can take away from the day-to-day coding that drives reimbursement.

Nym’s medical coding engine removes the stress associated with frequency coding updates. Our engine, which leverages multiple subfields of AI to instantly and accurately assign medical codes to patient charts, is updated to reflect new coding updates or guidelines as soon as they are published. Whenever a governing organization such as CMS or the American Medical Association releases information about an update, our team quickly assesses the specific updates, translates them into technical requirements, and then implements those modifications into the underlying software that powers the engine. The engine goes through a comprehensive testing and quality assurance process before the update goes live with any of our customers.

This process enables Nym to deploy the changes immediately as of the effective date of the update, taking the burden off of healthcare providers and ensuring that they remain compliant with new coding updates and guidelines from the get-go.

Interested in learning more about how Nym can help remove the risks associated with coding updates? Get in touch today.