CDC Releases New Diagnosis Codes

CMS also released Medicare Severity Diagnosis-Related Group (MS-DRG) V39.1

The Centers for Disease Control and Prevention (CDC) released its April 1, 2022 diagnosis files on Dec. 23, 2021. The updated files include a Tabular Addendum, Index Addendum, Official Coding and Reporting Guidelines update, ICD-10-CM Order File, and List of Codes and Descriptions. The Tabular Addendum and Index Addendum include minor updates to the classification, in addition to the new diagnosis codes.

The April 1 new diagnosis codes include:

  • Z28.310 – Unvaccinated for COVID-19;
  • Z28.311 – Partially vaccinated for COVID-19; and
  • Z28.39 – Other under-immunized status.

These codes have coding instructions. There is a note for the codes in subcategory Z28.31, which notes that “these codes should not be used for individuals who are not eligible for the COVID-19 vaccines, as determined by the healthcare provider.” The inclusion terms for Z28.39 include delinquent immunization status and lapsed immunization schedule status.

None of the new ICD-10-CM codes are designated as major complication/condition (MCC) or complication/condition (CC) status. These codes will become effective April 1, 2022, along with the previously released seven ICD-10-PCS codes.

In addition to the diagnosis codes released, the Centers for Medicare & Medicaid Services (CMS) also released Medicare Severity Diagnosis-Related Group (MS-DRG) V39.1, which also becomes effective April 1, 2022. The grouper update was created to include the new diagnosis and procedure codes.

There is also an update to the Medicare Code Editor (MCE). A new edit for unspecified laterality has been created as well. The diagnosis codes that trigger the new MCE are listed in the FY22 Inpatient Prospective Payment System (IPPS) Final Rule, Table 6P.3a.

There were also updates to the National Coverage Determination for Artificial Heart and Related Devices, with three procedure codes being removed from the Noncovered Procedure List and Limited Coverage Procedure List. These procedures are the following:

  • 02RK0JZ (Replacement of right ventricle with synthetic substitute, open approach);
  • 02RL0JZ (Replacement of left ventricle with synthetic substitute, open approach); and
  • 02WA0JZ (Revision of synthetic substitute in heart, open approach).

The National Coverage Determination for Ventricular Assist Devices was also updated, with the removal of these procedure codes from the Noncovered Procedure List:

  • 02WA3QZ (Revision of implantable heart assist system in heart, percutaneous approach); and
  • 02WA4QZ (Revision of implantable heart assist system in heart, percutaneous endoscopic approach).

These two codes were removed from the Limited Coverage Procedure List for the Ventricular Assist Devices as well:

  • 02HA0QZ (Insertion of implantable heart assist system into heart, open approach); and
  • 02WA0QZ (Revision of implantable heart assist system in heart, open approach).

In addition to the grouper update, CMS has also publicized the process to request new procedure codes and MS-DRG changes. Currently, dedicated mailboxes are used to request changes.

At the Coordination and Maintenance Committee meeting in March 2022, the Medicare Electronic Application Request Information System (MEARIS), which is an electronic application system, will be introduced. This system will have a soft launch in January 2022. CMS also plans to have a discussion regarding the new system in the FY23 rulemaking process.

Programming Note:

Listen to Laurie Johnson and her coding report every Tuesday on Talk Ten Tuesdays, 10 Eastern.

Print Friendly, PDF & Email
Facebook
Twitter
LinkedIn

Laurie M. Johnson, MS, RHIA, FAHIMA, AHIMA Approved ICD-10-CM/PCS Trainer

Laurie Johnson is currently a senior healthcare consultant for Revenue Cycle Solutions, based in Pittsburgh, Pa. Laurie is an AHIMA-approved ICD-10-CM/PCS trainer. She has more than 35 years of experience in health information management and specializes in coding and related functions. She has been a featured speaker in over 40 conferences. Laurie is a member of the ICD10monitor editorial board and is a permanent panelist on Talk Ten Tuesdays

Related Stories

Leave a Reply

Please log in to your account to comment on this article.

Featured Webcasts

Leveraging the CERT: A New Coding and Billing Risk Assessment Plan

Leveraging the CERT: A New Coding and Billing Risk Assessment Plan

Frank Cohen shows you how to leverage the Comprehensive Error Rate Testing Program (CERT) to create your own internal coding and billing risk assessment plan, including granular identification of risk areas and prioritizing audit tasks and functions resulting in decreased claim submission errors, reduced risk of audit-related damages, and a smoother, more efficient reimbursement process from Medicare.

April 9, 2024
2024 Observation Services Billing: How to Get It Right

2024 Observation Services Billing: How to Get It Right

Dr. Ronald Hirsch presents an essential “A to Z” review of Observation, including proper use for Medicare, Medicare Advantage, and commercial payers. He addresses the correct use of Observation in medical patients and surgical patients, and how to deal with the billing of unnecessary Observation services, professional fee billing, and more.

March 21, 2024
Top-10 Compliance Risk Areas for Hospitals & Physicians in 2024: Get Ahead of Federal Audit Targets

Top-10 Compliance Risk Areas for Hospitals & Physicians in 2024: Get Ahead of Federal Audit Targets

Explore the top-10 federal audit targets for 2024 in our webcast, “Top-10 Compliance Risk Areas for Hospitals & Physicians in 2024: Get Ahead of Federal Audit Targets,” featuring Certified Compliance Officer Michael G. Calahan, PA, MBA. Gain insights and best practices to proactively address risks, enhance compliance, and ensure financial well-being for your healthcare facility or practice. Join us for a comprehensive guide to successfully navigating the federal audit landscape.

February 22, 2024
Mastering Healthcare Refunds: Navigating Compliance with Confidence

Mastering Healthcare Refunds: Navigating Compliance with Confidence

Join healthcare attorney David Glaser, as he debunks refund myths, clarifies compliance essentials, and empowers healthcare professionals to safeguard facility finances. Uncover the secrets behind when to refund and why it matters. Don’t miss this crucial insight into strategic refund management.

February 29, 2024
2024 SDoH Update: Navigating Coding and Screening Assessment

2024 SDoH Update: Navigating Coding and Screening Assessment

Happy World Health Day! Our exclusive webcast is just $99 for a limited time! Use code WorldHealth24 at checkout before April 12th to claim this discount.

Dive deep into the world of Social Determinants of Health (SDoH) coding with our comprehensive webcast. Explore the latest OPPS codes for 2024, understand SDoH assessments, and discover effective strategies for integrating coding seamlessly into healthcare practices. Gain invaluable insights and practical knowledge to navigate the complexities of SDoH coding confidently. Join us to unlock the potential of coding in promoting holistic patient care.

May 22, 2024
2024 ICD-10-CM/PCS Coding Clinic Update Webcast Series

2024 ICD-10-CM/PCS Coding Clinic Update Webcast Series

HIM coding expert, Kay Piper, RHIA, CDIP, CCS, reviews the guidance and updates coders and CDIs on important information in each of the AHA’s 2024 ICD-10-CM/PCS Quarterly Coding Clinics in easy-to-access on-demand webcasts, available shortly after each official publication.

April 15, 2024

Trending News

Happy World Health Day! Our exclusive webcast, ‘2024 SDoH Update: Navigating Coding and Screening Assessment,’  is just $99 for a limited time! Use code WorldHealth24 at checkout.

SPRING INTO SAVINGS! Get 21% OFF during our exclusive two-day sale starting 3/21/2024. Use SPRING24 at checkout to claim this offer. Click here to learn more →