New ICD-10-CM/PCS Codes Warrant Attention

Here is an important checklist to help you prepare for new codes effective now.

On Oct. 1, the new 2022 fiscal year (FY) ICD-10-CM/PCS codes became effective. The new CM code set includes 159 new codes, 20 revised codes, and 18 deleted codes. The new ICD-10-PCS code set include 191 new codes, 62 revised titles, and 107 deleted codes. Most of the new procedure codes are in the Medical/Surgical section, followed by New Technology.

To prepare for the new fiscal year, there is a checklist of tasks to complete:

    1. Review and educate on the new diagnosis and procedure codes. There are many webinars that review the code changes. It is recommended that you and your coding staff listen, or review a code update.
    2. Identify and educate on New Technology items. There are 38-39 substances or devices that are newly active for the fiscal year. Review the list with pharmacy, central stores, or the OR, and then compare with the list of items used by your facility. Identify the documentation that would trigger a coder to confirm use and assign a procedure code for the New Technology items.
    3. Review changes to the MS-DRG. You may want to work with finance to understand how the changes will impact your bottom line.
    4. Update your facility-specific coding guidelines to incorporate the FY 2022 changes. Maintain a copy of your previous facility coding guidelines that may be used for any retrospective audits.
    5. Review and update query templates for the fiscal year. Review query response statistics and determine which templates may need to be updated to increase physician response.

This is also a good time to determine baselines:

    1. Calculate your complication and comborbidity (CC) and major CC (MCC) capture rate as of the end of September 2021. I like reviewing this information on a quarterly basis to monitor the effectiveness of clinical documentation improvement (CDI) and coding staffs. If you need assistance in this calculation, there is an American Health Information Management Association (AHIMA) Practice Brief on the subject.
    2. Determine the accuracy rate overall, and for each of your coders. If you haven’t completed internal quality reviews, you may want to have an external audit. Coding reviews are a great method of providing feedback to the coders and determining if additional education is warranted.

October would also be a good time to begin the discussion on social determinants of health (SDoH). Determine what areas of SDoH for which your organization has a data need. You may need to collaborate with contracting, as some payor contracts may include SDoH requirements. It is important that every organization realize that coders can capture this data.

The Talk Ten Tuesdays Listener’s Survey from Sept. 28 revealed that most organizations have reviewed the new ICD-10-CM/PCS codes and have done some other tasks to prepare for the fiscal year. It is imperative that the New Technology Add-On Payment (NTAP) items be identified and shared with coding staffs so that each organization will receive additional monies. This payment is based on the ICD-10-PCS codes that identify the NTAP items. These items are listed in the FY 2022 Inpatient Prospective Payment System (IPPS) Final Rule or available for review by listening to the ICD University webcast on the FY 2022 IPPS.

Programming Note: Listen to Laurie Johnson’s live coding report every Tuesday on Talk Ten Tuesdays, 10 Eastern.

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

I050825

Mastering ICD-10-CM Coding for Diabetes and it’s Complications: Avoiding Denials & Ensuring Compliance

Struggling with ICD-10-CM coding for diabetes and complications? This expert-led webcast clarifies complex combination codes, documentation gaps, and sequencing rules to reduce denials and ensure compliance. Dr. Angela Comfort will provide actionable strategies to accurately link diabetes to complications, improve provider documentation, and optimize reimbursement—helping coders, CDI specialists, and HIM leaders minimize audit risks and strengthen revenue integrity. Don’t miss this chance to master diabetes coding with real-world case studies, key takeaways, and live Q&A!

May 8, 2025

Trending News

Featured Webcasts

Audit-Proof Your Wound Care Procedures: Expert Insights on Compliance and Risk Mitigation

Audit-Proof Your Wound Care Procedures: Expert Insights on Compliance and Risk Mitigation

Providers face increasing Medicare audits when using skin substitute grafts, leaving many unprepared for claim denials and financial liabilities. Join veteran healthcare attorney Andrew B. Wachler, Esq., in this essential webcast and master the Medicare audit process, learn best practices for compliant billing and documentation, and mitigate fraud and abuse risks. With actionable insights and a live Q&A session, you’ll gain the tools to defend your practice and ensure compliance in this rapidly evolving landscape.

April 17, 2025
Utilization Review Essentials: What Every Professional Needs to Know About Medicare

Utilization Review Essentials: What Every Professional Needs to Know About Medicare

Dr. Ronald Hirsch dives into the basics of Medicare for clinicians to be successful as utilization review professionals. He’ll break down what Medicare does and doesn’t pay for, what services it provides and how hospitals get paid for providing those services – including both inpatient and outpatient. Learn how claims are prepared and how much patients must pay for their care. By attending our webcast, you will gain a new understanding of these issues and be better equipped to talk to patients, to their medical staff, and to their administrative team.

March 20, 2025

Rethinking Observation Metrics: Standardizing Data for Better Outcomes

Hospitals face growing challenges in measuring observation metrics due to inconsistencies in classification, payer policies, and benchmarking practices. Join Tiffany Ferguson, LMSW, CMAC, ACM, and Anuja Mohla, DO, FACP, MBA, ACPA-C, CHCQM-PHYADV as they provide critical insights into refining observation metrics. This webcast will address key issues affecting observation data integrity and offer strategies for improving consistency in reporting. You will learn how to define meaningful metrics, clarify commonly misinterpreted terms, and apply best practices for benchmarking, and gain actionable strategies to enhance observation data reliability, mitigate financial risk, and drive better decision-making.

February 25, 2025
Navigating the 2025 Medicare Physician Fee Schedule: Key Changes and Strategies for Success

Navigating the 2025 Medicare Physician Fee Schedule: Key Changes and Strategies for Success

The 2025 Medicare Physician Fee Schedule brings significant changes to payment rates, coverage, and coding for physician services, impacting practices nationwide. Join Stanley Nachimson, MS., as he provides a comprehensive guide to understanding these updates, offering actionable insights on new Medicare-covered services, revised coding rules, and payment policies effective January 1. Learn how to adapt your practices to maintain compliance, maximize reimbursement, and plan for revenue in 2025. Whether you’re a physician, coder, or financial staff member, this session equips you with the tools to navigate Medicare’s evolving requirements confidently and efficiently.

January 21, 2025

Trending News

Celebrate Lab Week with MedLearn! Sign up to win one year of our Laboratory All Access Pass! Click here to learn more →

Prepare for the 2025 CMS IPPS Final Rule with ICD10monitor’s IPPSPalooza! Click HERE to learn more

Get 15% OFF on all educational webcasts at ICD10monitor with code JULYFOURTH24 until July 4, 2024—start learning today!

CYBER WEEK IS HERE! Don’t miss your chance to get 20% off now until Dec. 2 with code CYBER24