FY 2022 ICD-10-CM Guidelines Are Here

The Centers for Disease Control and Prevention (CDC) published the ICD-10-CM Official Coding and Reporting Guidelines for the 2022 fiscal year (FY) on July 12. There are 115 pages in the new release, a decrease of 11 pages from the FY 2021 version. These guidelines become effective with Oct. 1, 2021 discharges/visits.

Narrative changes appear in bold text; underlined items have been moved within the guidelines since the FY 2021 version; italics are used to indicate revisions to headings.

Here are some of the changes for Section I (Conventions, General Coding Guidelines, and Chapter-Specific Guidelines) for sections A (Conventions) and B (General Coding Guidelines). The title for Chapter 21, subsection B-Z codes, Indicate a Reason for Encounter, has been added to include “or Provide Additional Information about a Patient Encounter.” For Section B (General Coding Guidelines), No. 2 (Level of Detail in Coding) has expanded the sentence of “diagnosis codes are to be used and reported at their highest number of characters available” to include “and to the highest level of specificity documented in the medical record.” No. 13 (Laterality) has added a paragraph regarding the specificity of laterality, stating that unspecified codes should rarely be used. The provider should be queried when conflicting or unclear documentation is present. No. 14 (Documentation by Other than the Patient’s Provider) has added a definition of “clinician,” as well as a list of exceptions where healthcare professionals may be used. There have been additional updates indicating that body mass index (BMI), coma scale, NIHSS, blood alcohol level, and codes for social determinants of health (SDoH) should only be reported as secondary codes. No. 18 (Use of Sign/Symptom/Unspecified Codes) has a new paragraph to emphasize the important of consistent, complete documentation in the medical record.

That is a glimpse into the changes in the Official Coding and Reporting Guidelines for ICD-10-CM FY 2022. These changes will be reviewed in further depth, along with the chapter-specific changes, during the 2022 Inpatient Prospective Payment System (IPPS) Summit: Master ICD-10-CM Changes on Aug. 17.  

The Talk Ten Tuesdays Listeners Survey on July 13 asked, “which Official Coding and Reporting Guidelines are more impactful to you?” This revealed the following results:

1. ICD-10-CM: 89 percent
2. ICD-10-PCS: 5 percent
3. Does Not Apply: 7 percent

Based on the results of this survey, the changes in the ICD-10-CM guidelines are very important to the audience. Remember that the guidelines and code changes will be further explained in an upcoming issue of the American Hospital Association’s (AHA’s) Coding Clinic.

Please note that a new version of the FY 2022 Conversion file for ICD-10-CM was released on June 30. This file helps the user translate from previous code versions to the current version, or in reverse as well.

Programming Note:

Listen to live reporting by Laurie Johnson during Talk Ten Tuesdays at 10 Eastern.