by Christine Woolstenhulme, QMC QCC CMCS CPC CMRS
Oct 6th, 2022
In 2022 there were 159 new codes; the 2023 ICD-10-CM code update includes 1,176 new, 28 revised, and 287 deleted codes, a substantial change from last year. The 2023 ICD-10-CM codes are to be used for discharges from October 1, 2022 through September 30, 2023, and for patient encounters from October 1, 2022 through September 30, 2023.
Significant Changes- New Codes
Some of the most notable changes are in dementia, endometriosis, maternal care for fetal disorders, and head injuries. In addition, with the new electric bikes becoming so popular, they have added motorcycle/electric bike accidents and deleted several types of motorcycle accidents/collisions, for example, V20.11 Electric (assisted) bicycle passenger injured in collision with pedestrian or animal in nontraffic.
Injuries to the head (S00-S09) have 86 new codes, including the following concussion codes:
- S06.0XAA, concussion with loss of consciousness status unknown, initial encounter
- S06.0XAD, concussion with loss of consciousness status unknown, subsequent encounter
- S06.0XAS, concussion with loss of consciousness status unknown, sequela
Chapter 9. Diseases of the circulatory system (I00-I99) have 85 new codes, including the following aneurysm codes:
- I71.10, Thoracic aortic aneurysm, ruptured, unspecified
- I17.11, Aneurysm of the ascending aorta, ruptured
- I71.12, Aneurysm of the aortic arch, ruptured
Social Determinants Added
Social determinants of health (SDOH) have been added to Chapter 21- Factors influencing health status and contact with health services. SDOH is a new concept to track conditions contributing to health, quality of life, and risks in the environments where people are born, live and work, to name a few. There are three new Social Determinants of Health (SDOH) codes Z59. 82 transportation insecurity, Z59. 86 financial insecurity and Z59. 87 material hardship.
Code Description Changes in Chapter 6 (no longer dementia)
A few of the changes made in Chapter 6: Diseases of the nervous system include replacing the word "dementia" in codes G31.09 and G31.83. "Dementia" has been replaced with the term "neurocognitive disorder." For example, the current descriptor for "Other frontotemporal dementia" is now "Other frontotemporal neurocognitive disorder." Keep an eye on the code sequencing or "use additional code" note to fully report the condition. According to the common language description by the AMA, "When the documentation identifies another type of FTD (other than Pick's), it is reported as Other frontotemporal dementia (G31.09.)."
Dementia Codes Expanded
With the expansion of dementia codes, code F01.51 (Vascular dementia with behavioral disturbance) is no longer being used; 23 new codes are replacing F01.51. The CMS initiative to gather clinical data to enhance care for dementia patients requires additional detail in the documentation. The information below will address the new 2023 requirements for reporting and tracking dementia codes. The new codes include the behavioral and psychological symptoms of dementia (BPSD) and will be used for collecting data on the associated conditions.
The severity of dementia is now identified as mild, moderate, and severe. Other characteristics and changes are associated with behavioral and psychological conditions, such as agitation, psychosis, mood, psychotic disturbance, mood disturbance, and anxiety. There are three types of conditions associated with dementia that are now considered in the new codes.
Psychotic disorders associated with dementia are identified in the code inclusion terms as hallucinations, paranoia, suspiciousness, and delusional state.
Mood disorders associated with dementia are identified in the code inclusion terms as depression, apathy (lacking emotion), and anhedonia (decreased ability to feel pleasure). Studies have shown a correlation between mood disorders and lower quality of life scores.
Use additional code, if applicable, to identify wandering in unspecified dementia (Z91.83- Wandering in diseases classified elsewhere) with some of the new codes, such as G31.09 and G31.83.
| Types of Severity | Description of Severity |
| 1. Mild dementia | Clearly evident functional impact on daily life, affecting mainly instrumental activities. No longer fully independent/requires occasional assistance with daily living activities. |
| 2. Moderate dementia | Extensive functional impact on daily life with impairment in basic activities. No longer independent and requires frequent assistance with daily living activities |
| 3. Severe dementia | Clinical interview may not be possible. Complete dependency due to severe functional impact on daily life with impairment in basic activities, including basic self-care |
| Conditions and Behaviors | |
| Associated Conditions | 1. Agitation 2. Psychosis 3. Mood |
| Additional Details Used in Expansion of Codes |
|
| Psychological Behaviors | Including agitation, psychotic disturbance, mood disturbance, and anxiety. Psychotic disorders associated with dementia are identified in the code inclusion terms as hallucinations, paranoia, suspiciousness, and delusional state. |
| Motor Behaviors | Including restlessness, rocking, pacing, and exit seeking. |
| Other Behavior Disturbance | Profanity, shouting, threatening, anger, aggression, and combativeness, violence, sleep disturbances, social disinhibition, sexual disinhibition. |
For additional ICD-10-CM code changes, visit Find-A-Code.
New Codes for 2023
Changed Codes for 2023
Deleted Codes for 2023
We also have Past Changes by Year
References/Resources
About Christine Woolstenhulme, QMC QCC CMCS CPC CMRS
Christine Woolstenhulme, CPC, QCC, CMCS, CMRS, is a Certified coder and Medical Biller currently employed with Find-A-Code. Bringing over 30 years of insight, business knowledge, and innovation to the healthcare industry. Establishing a successful Medical Billing Company from 1994 to 2015, during this time, Christine has had the opportunity to learn all aspects of revenue cycle management while working with independent practitioners and in clinic settings. Christine was a VAR for AltaPoint EHR software sales, along with management positions and medical practice consulting. Understanding the complete patient engagement cycle and developing efficient processes to coordinate teams ensuring best practice standards in healthcare. Working with payers on coding and interpreting ACA policies according to state benchmarks and insurance filings and implementing company procedures and policies to coordinate teams and payer benefits.
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