More Related Content Similar to Vitalware Insight Into the 2024 ICD10 CM Updates.pdf (20) More from Health Catalyst (20) Vitalware Insight Into the 2024 ICD10 CM Updates.pdf1. © Health Catalyst. Confidential and Proprietary.
Insight into the 2024 ICD-10-CM Updates
Mikki Fazzio, RHIT, CCS, Charge Integrity Specialist
2. © Health Catalyst. Confidential and Proprietary.
Disclaimer Statement
This presentation was current at the time it was published or provided via the web and is
designed to provide accurate and authoritative information regarding the subject matter
covered. The information provided is only intended to be a general overview with the
understanding that neither the presenter nor the event sponsor is engaged in rendering
specific coding advice. It is not intended to take the place of either the written policies or
regulations. We encourage participants to review the specific regulations and other
interpretive materials, as necessary.
All CPT® codes are trademarked by the American Medical Association (AMA) and all
revenue codes are copyrighted by the American Hospital Association (AHA).
3. Agenda
© Health Catalyst. Confidential and Proprietary.
• MCC/CC Changes
• ICD-10-CM Chapter-Specific
Code Additions, Deletions, and
Revisions
• ICD-10-CM Guideline Changes
• MS-DRG Updates
4. © Health Catalyst. Confidential and Proprietary.
CM Code Changes Summary
For FY 2024 Overall Changes to CM:
• 395 new codes
• 13 revisions
• 25 deletions
Total CM codes from 73,674 to 74,044
• 429 new POA exempt codes added, 8 POA exempt codes deleted
• MCC/CC Changes:
– 18 new MCCs
– 3 deleted MCCs
– 79 new CCs
– 8 deleted CCs
6. © Health Catalyst. Confidential and Proprietary.
Additions to MCC List
MCC and CC Changes
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Deletions to MCC List
MCC and CC Changes
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Additions to CC List
MCC and CC Changes
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Deletions to CC List
MCC and CC Changes
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ICD-10-CM Chapter
Specific Code Additions,
Deletions, and Revisions
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Additions
A41.54 Sepsis due to Acinetobacter baumannii MCC
B96.83 Acinetobacter baumannii as the cause of diseases classified elsewhere
Chapter 1: Certain Infectious and Parasitic Diseases
ICD-10-CM Code Additions, Deletions, and Revisions
12. © Health Catalyst. Confidential and Proprietary.
Additions
D13.91 Familial adenomatous polyposis
D13.99 Benign neoplasm of ill-defined sites within the digestive system
[Deletion: D13.9 Benign neoplasm of ill-defined sites within the digestive system]
D48.110 Desmoid tumor of head and neck
D48.111 Desmoid tumor of chest wall
D48.112 Desmoid tumor, intrathoracic
D48.113 Desmoid tumor of abdominal wall
D48.114 Desmoid tumor, intraabdominal
Chapter 2: Neoplasms
ICD-10-CM Code Additions, Deletions, and Revisions
13. © Health Catalyst. Confidential and Proprietary.
Additions
D48.115 Desmoid tumor of upper extremity and shoulder girdle
D48.116 Desmoid tumor of lower extremity and pelvic girdle
D48.117 Desmoid tumor of back
D48.118 Desmoid tumor of other site
D48.119 Desmoid tumor of unspecified site
D48.19 Other specified neoplasm of uncertain behavior of connective and other
soft tissue
[Deletion: D48.1, Neoplasm of uncertain behavior of connective and other soft tissue]
Chapter 2: Neoplasms
ICD-10-CM Code Additions, Deletions, and Revisions
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Chapter 2: Neoplasms
ICD-10-CM Code Additions, Deletions, and Revisions
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Additions
D61.02 Shwachman-Diamond syndrome CC
• Code also, if applicable, associated conditions such as: acute myeloblastic
leukemia (C92.0-), exocrine pancreatic insufficiency (K86.81), myelodysplastic
syndrome (D46.-)
• Use additional code, if applicable, for genetic susceptibility to other malignant
neoplasm (Z15.09)
D89.84 IgG4-related disease
Chapter 3: Diseases of Blood/Blood-Forming Organs & Disorders Involving Immune Mechanism
ICD-10-CM Code Additions, Deletions, and Revisions
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Additions
D57.04 Hb-SS disease with dactylitis MCC
D57.214 Sickle-cell/Hb-C disease with dactylitis MCC
D57.414 Sickle-cell thalassemia, unspecified, with dactylitis MCC
D57.434 Sickle-cell thalassemia beta zero with dactylitis MCC
D57.454 Sickle-cell thalassemia beta plus with dactylitis MCC
D57.814 Other sickle-cell disorders with dactylitis MCC
Chapter 3: Diseases of Blood/Blood-Forming Organs & Disorders Involving Immune Mechanism
ICD-10-CM Code Additions, Deletions, and Revisions
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Additions
E20.810 Autosomal dominant hypocalcemia
• Code also, if applicable, any associated conditions, such as: calculus of kidney (N20.0), chronic kidney
disease (N18.-), respiratory distress (J80, R06.-), seizure disorder (G40.-, R56.9)
E20.811 Secondary hypoparathyroidism in diseases classified elsewhere
E20.812 Autoimmune hypoparathyroidism
E20.818 Other specified hypoparathyroidism due to impaired parathyroid hormone secretion
E20.819 Hypoparathyroidism due to impaired parathyroid hormone secretion, unspecified
E20.89 Other specified hypoparathyroidism
[Deletion: E20.8 Other hypoparathyroidism]
Chapter 4: Endocrine, Nutritional and Metabolic Diseases
ICD-10-CM Code Additions, Deletions, and Revisions
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Additions
E88.811 Insulin resistance syndrome, Type A
E88.818 Other insulin resistance
E88.819 Insulin resistance, unspecified
E88.810 Metabolic syndrome
E74.05 Lysosome-associated membrane protein 2 [LAMP2] deficiency CC
• Code also, if applicable, associated manifestations such as: dilated cardiomyopathy (I42.0),
obstructive hypertrophic cardiomyopathy (I42.1)
Chapter 4: Endocrine, Nutritional and Metabolic Diseases
ICD-10-CM Code Additions, Deletions, and Revisions
19. © Health Catalyst. Confidential and Proprietary.
E75.27 Pelizaeus-Merzbacher disease CC
E75.28 Canavan disease CC
E79.81 Aicardi-Goutieres syndrome CC
E79.82 Hereditary xanthinuria CC
E79.89 Other specified disorders of purine and pyrimidine metabolism CC
[Deletion: E79.8 Other disorders of purine and pyrimidine metabolism]
[Deletion: E88.81 Metabolic Syndrome]
Chapter 4: Endocrine, Nutritional and Metabolic Diseases
Additions
ICD-10-CM Code Additions, Deletions, and Revisions
20. © Health Catalyst. Confidential and Proprietary.
Additions
E88.43 Disorders of mitochondrial tRNA synthetases CC
E88.A Wasting disease (syndrome) due to underlying condition
• Code first the underlying condition.
• This is no longer coded as part of category R64, Cachexia.
Chapter 4: Endocrine, Nutritional and Metabolic Diseases
ICD-10-CM Code Additions, Deletions, and Revisions
21. © Health Catalyst. Confidential and Proprietary.
Additions
G20.A1 Parkinson's disease without dyskinesia, without mention of fluctuations
G20.A2 Parkinson's disease without dyskinesia, with fluctuations
G20.B1 Parkinson's disease with dyskinesia, without mention of fluctuations
G20.B2 Parkinson's disease with dyskinesia, with fluctuations
G20.C Parkinsonism, unspecified
[Deletion: G20 Parkinson’s disease]
G37.81 Myelin oligodendrocyte glycoprotein antibody disease CC
• Code also associated manifestations, if known, such as: noninfectious acute disseminated
encephalomyelitis (G04.81), neuromyelitis optica (G36.0)
G37.89 Other specified demyelinating diseases of central nervous system CC
[Deletion: G37.8 Other specified demyelinating diseases of central nervous system]
Chapter 6: Diseases of the Nervous System
ICD-10-CM Code Additions, Deletions, and Revisions
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Additions
G40.C01 Lafora progressive myoclonus epilepsy, not intractable, with status epilepticus CC
G40.C09 Lafora progressive myoclonus epilepsy, not intractable, without status epilepticus CC
G40.C11 Lafora progressive myoclonus epilepsy, intractable, with status epilepticus CC
G40.C19 Lafora progressive myoclonus epilepsy, intractable, without status epilepticus CC
• Code also, if applicable, associated conditions such as dementia (F02.8-)
Chapter 6: Diseases of the Nervous System
ICD-10-CM Code Additions, Deletions, and Revisions
23. © Health Catalyst. Confidential and Proprietary.
Additions
G43.E01 Chronic migraine with aura, not intractable, with status migrainosus
G43.E09 Chronic migraine with aura, not intractable, without status migrainosus
G43.E11 Chronic migraine with aura, intractable, with status migrainosus
G43.E19 Chronic migraine with aura, intractable, without status migrainosus
G93.42 Megaloencephalic leukoencephalopathy with subcortical cysts CC
G93.43 Leukoencephalopathy with calcifications and cysts CC
G23.3 Hypomyelination with atrophy of the basal ganglia and cerebellum CC
G31.86 Alexander disease
Chapter 6: Diseases of the Nervous System
ICD-10-CM Code Additions, Deletions, and Revisions
24. © Health Catalyst. Confidential and Proprietary.
Additions
G11.5 Hypomyelination - hypogonadotropic hypogonadism – hypodontia CC
G11.6 Leukodystrophy with vanishing white matter disease CC
G23.3 Hypomyelination with atrophy of the basal ganglia and cerebellum CC
G31.80 Leukodystrophy, unspecified
G90.B LMNB1-related autosomal dominant leukodystrophy
G93.44 Adult-onset leukodystrophy with axonal spheroids CC
Chapter 6: Diseases of the Nervous System
ICD-10-CM Code Additions, Deletions, and Revisions
25. © Health Catalyst. Confidential and Proprietary.
Additions
H36.811 Nonproliferative sickle-cell retinopathy, right eye
H36.812 Nonproliferative sickle-cell retinopathy, left eye
H36.813 Nonproliferative sickle-cell retinopathy, bilateral
H36.819 Nonproliferative sickle-cell retinopathy, unspecified eye
H36.821 Proliferative sickle-cell retinopathy, right eye
H36.822 Proliferative sickle-cell retinopathy, left eye
H36.823 Proliferative sickle-cell retinopathy, bilateral
H36.829 Proliferative sickle-cell retinopathy, unspecified eye
• Code first underlying disease, such as: lipid storage disorders (E15.-) or sickle-cell disorders (D57.-)
[Deletion: H36 Retinal disorders in diseases classified elsewhere]
Chapter 7: Diseases of the Eye and Adnexa
ICD-10-CM Code Additions, Deletions, and Revisions
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Additions
H57.8A1 Foreign body sensation, right eye
H57.8A2 Foreign body sensation, left eye
H57.8A3 Foreign body sensation, bilateral eyes
H57.8A9 Foreign body sensation, unspecified eye
H36.89 Other retinal disorders in diseases classified elsewhere
Chapter 7: Diseases of the Eye and Adnexa
ICD-10-CM Code Additions, Deletions, and Revisions
27. © Health Catalyst. Confidential and Proprietary.
Chapter 7: Diseases of the Eye and Adnexa
ICD-10-CM Code Additions, Deletions, and Revisions
Additions
H50.621 Inferior oblique muscle entrapment, right eye
H50.622 Inferior oblique muscle entrapment, left eye
H50.629 Inferior oblique muscle entrapment, unspecified eye
H50.631 Inferior rectus muscle entrapment, right eye
H50.632 Inferior rectus muscle entrapment, left eye
H50.639 Inferior rectus muscle entrapment, unspecified eye
H50.641 Lateral rectus muscle entrapment, right eye
H50.642 Lateral rectus muscle entrapment, left eye
H50.649 Lateral rectus muscle entrapment, unspecified eye
H50.651 Medial rectus muscle entrapment, right eye
H50.652 Medial rectus muscle entrapment, left eye
• Code the muscle entrapment in addition to the orbital fracture
H50.659 Medial rectus muscle entrapment, unspecified eye
H50.661 Superior oblique muscle entrapment, right eye
H50.662 Superior oblique muscle entrapment, left eye
H50.669 Superior oblique muscle entrapment, unspecified eye
H50.671 Superior rectus muscle entrapment, right eye
H50.672 Superior rectus muscle entrapment, left eye
H50.679 Superior rectus muscle entrapment, unspecified eye
H50.681 Extraocular muscle entrapment, unspecified, right eye
H50.682 Extraocular muscle entrapment, unspecified, left eye
H50.689 Extraocular muscle entrapment, unspecified, unspecified eye
28. © Health Catalyst. Confidential and Proprietary.
Additions
I1A.0 Resistant hypertension
• Code first specific type of existing hypertension, if known, such as: essential hypertension (I10) or secondary hypertension (I15.-)
I20.81 Angina pectoris with coronary microvascular dysfunction
I20.89 Other forms of angina pectoris
[Deletion: I20.8 Other forms of angina pectoris]
I21.B Myocardial infarction with coronary microvascular dysfunction MCC
I24.81 Acute coronary microvascular dysfunction CC
I24.89 Other forms of acute ischemic heart disease CC
I25.85 Chronic coronary microvascular dysfunction
[Deletion: I24.8 Other forms of acute ischemic heart disease]
Chapter 9: Diseases of the Circulatory System
ICD-10-CM Code Additions, Deletions, and Revisions
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Additions
I47.10 Supraventricular tachycardia, unspecified CC
I47.11 Inappropriate sinus tachycardia, so stated CC
I47.19 Other supraventricular tachycardia CC
[Deletion: I47.1 Supraventricular tachycardia]
Chapter 9: Diseases of the Circulatory System
ICD-10-CM Code Additions, Deletions, and Revisions
30. © Health Catalyst. Confidential and Proprietary.
I25.112, Atherosclerosic heart disease of native coronary artery with refractory angina pectoris
Revised to:
I25.112, Atherosclerotic heart disease of native coronary artery with refractory angina pectoris
Chapter 9: Diseases of the Circulatory System
ICD-10-CM Code Additions, Deletions, and Revisions
31. © Health Catalyst. Confidential and Proprietary.
I71.51, Supraceliac aneurysm of the abdominal aorta, ruptured
I71.61, Supraceliac aneurysm of the abdominal aorta, without rupture
Revised to:
I71.51, Supraceliac aneurysm of the thoracoabdominal aorta, ruptured
I71.61, Supraceliac aneurysm of the thoracoabdominal aorta, without rupture
Chapter 9: Diseases of the Circulatory System
ICD-10-CM Code Additions, Deletions, and Revisions
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I71.52, Paravisceral aneurysm of the abdominal aorta, ruptured
I71.62, Paravisceral aneurysm of the abdominal aorta, without rupture
Revised to:
I71.52, Paravisceral aneurysm of the thoracoabdominal aorta, ruptured
I71.62, Paravisceral aneurysm of the thoracoabdominal aorta, without rupture
Chapter 9: Diseases of the Circulatory System
ICD-10-CM Code Additions, Deletions, and Revisions
33. © Health Catalyst. Confidential and Proprietary.
Additions
J15.61 Pneumonia due to Acinetobacter baumannii MCC
J15.69 Pneumonia due to other Gram-negative bacteria MCC
[Deletion: J15.6 Pneumonia due to other Gram-negative bacteria]
J44.81 Bronchiolitis obliterans and bronchiolitis obliterans syndrome
J44.89 Other specified chronic obstructive pulmonary disease
J4A.0 Restrictive allograft syndrome
J4A.8 Other chronic lung allograft dysfunction
J4A.9 Chronic lung allograft dysfunction, unspecified
Chapter 10: Diseases of the Respiratory System
ICD-10-CM Code Additions, Deletions, and Revisions
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Additions
K35.200 Acute appendicitis with generalized peritonitis, without perforation or abscess CC
K35.201 Acute appendicitis with generalized peritonitis, with perforation, without abscess CC
K35.209 Acute appendicitis with generalized peritonitis, without abscess, unspecified as to perforation CC
K35.210 Acute appendicitis with generalized peritonitis, without perforation, with abscess MCC
K35.211 Acute appendicitis with generalized peritonitis, with perforation and abscess MCC
K35.219 Acute appendicitis with generalized peritonitis, with abscess, unspecified as to perforation MCC
[Deletion: K35.20 Acute appendicitis with generalized peritonitis, without abscess and K3521 Acute appendicitis with generalized peritonitis, with
abscess]
K63.8211 Small intestinal bacterial overgrowth, hydrogen-subtype
K63.8212 Small intestinal bacterial overgrowth, hydrogen sulfide-subtype
K63.8219 Small intestinal bacterial overgrowth, unspecified
K63.822 Small intestinal fungal overgrowth
K63.829 Intestinal methanogen overgrowth, unspecified
Chapter 11: Diseases of the Digestive System
ICD-10-CM Code Additions, Deletions, and Revisions
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Additions
K68.2 Retroperitoneal fibrosis MCC
• Code also, if applicable, associated obstruction of ureter (N13.5)
K68.3 Retroperitoneal hematoma MCC
K90.821 Short bowel syndrome with colon in continuity CC
K90.822 Short bowel syndrome without colon in continuity CC
K90.829 Short bowel syndrome, unspecified CC
K90.83 Intestinal failure CC
Chapter 11: Diseases of the Digestive System
ICD-10-CM Code Additions, Deletions, and Revisions
36. © Health Catalyst. Confidential and Proprietary.
Additions
M80.0B1A Age-related osteoporosis with current pathological fracture, right pelvis, initial encounter for fracture
M80.0B1D Age-related osteoporosis with current pathological fracture, right pelvis, subsequent encounter for fracture with routine healing
M80.0B1G Age-related osteoporosis with current pathological fracture, right pelvis, subsequent encounter for fracture with delayed healing
M80.0B1K Age-related osteoporosis with current pathological fracture, right pelvis, subsequent encounter for fracture with nonunion
M80.0B1P Age-related osteoporosis with current pathological fracture, right pelvis, subsequent encounter for fracture with malunion
M80.0B1S Age-related osteoporosis with current pathological fracture, right pelvis, sequela
M80.0B2A Age-related osteoporosis with current pathological fracture, left pelvis, initial encounter for fracture
M80.0B2D Age-related osteoporosis with current pathological fracture, left pelvis, subsequent encounter for fracture with routine healing
M80.0B2G Age-related osteoporosis with current pathological fracture, left pelvis, subsequent encounter for fracture with delayed healing
M80.0B2K Age-related osteoporosis with current pathological fracture, left pelvis, subsequent encounter for fracture with nonunion
M80.0B2P Age-related osteoporosis with current pathological fracture, left pelvis, subsequent encounter for fracture with malunion
M80.0B2S Age-related osteoporosis with current pathological fracture, left pelvis, sequela
Chapter 13: Diseases of the Musculoskeletal System and Connective Tissue
ICD-10-CM Code Additions, Deletions, and Revisions
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Additions
M80.0B9A Age-related osteoporosis with current pathological fracture, unspecified pelvis, initial encounter for fracture
M80.0B9D Age-related osteoporosis with current pathological fracture, unspecified pelvis, subsequent encounter for fracture with routine healing
M80.0B9G Age-related osteoporosis with current pathological fracture, unspecified pelvis, subsequent encounter for fracture with delayed healing
M80.0B9K Age-related osteoporosis with current pathological fracture, unspecified pelvis, subsequent encounter for fracture with nonunion
M80.0B9P Age-related osteoporosis with current pathological fracture, unspecified pelvis, subsequent encounter for fracture with malunion
M80.0B9S Age-related osteoporosis with current pathological fracture, unspecified pelvis, sequela
M80.8B1A Other osteoporosis with current pathological fracture, right pelvis, initial encounter for fracture
M80.8B1D Other osteoporosis with current pathological fracture, right pelvis, subsequent encounter for fracture with routine healing
M80.8B1G Other osteoporosis with current pathological fracture, right pelvis, subsequent encounter for fracture with delayed healing
M80.8B1K Other osteoporosis with current pathological fracture, right pelvis, subsequent encounter for fracture with nonunion
M80.8B1P Other osteoporosis with current pathological fracture, right pelvis, subsequent encounter for fracture with malunion
M80.8B1S Other osteoporosis with current pathological fracture, right pelvis, sequela
Chapter 13: Diseases of the Musculoskeletal System and Connective Tissue
ICD-10-CM Code Additions, Deletions, and Revisions
38. © Health Catalyst. Confidential and Proprietary.
Additions
M80.8B2A Other osteoporosis with current pathological fracture, left pelvis, initial encounter for fracture
M80.8B2D Other osteoporosis with current pathological fracture, left pelvis, subsequent encounter for fracture with routine healing
M80.8B2G Other osteoporosis with current pathological fracture, left pelvis, subsequent encounter for fracture with delayed healing
M80.8B2K Other osteoporosis with current pathological fracture, left pelvis, subsequent encounter for fracture with nonunion
M80.8B2P Other osteoporosis with current pathological fracture, left pelvis, subsequent encounter for fracture with malunion
M80.8B2S Other osteoporosis with current pathological fracture, left pelvis, sequela
M80.8B9A Other osteoporosis with current pathological fracture, unspecified pelvis, initial encounter for fracture
M80.8B9D Other osteoporosis with current pathological fracture, unspecified pelvis, subsequent encounter for fracture with routine healing
M80.8B9G Other osteoporosis with current pathological fracture, unspecified pelvis, subsequent encounter for fracture with delayed healing
M80.8B9K Other osteoporosis with current pathological fracture, unspecified pelvis, subsequent encounter for fracture with nonunion
M80.8B9P Other osteoporosis with current pathological fracture, unspecified pelvis, subsequent encounter for fracture with malunion
M80.8B9S Other osteoporosis with current pathological fracture, unspecified pelvis, sequela
Chapter 13: Diseases of the Musculoskeletal System and Connective Tissue
ICD-10-CM Code Additions, Deletions, and Revisions
39. © Health Catalyst. Confidential and Proprietary.
Additions
N02.B1 Recurrent and persistent immunoglobulin A nephropathy with glomerular lesion CC
N02.B2 Recurrent and persistent immunoglobulin A nephropathy with focal and segmental glomerular
lesion CC
N02.B3 Recurrent and persistent immunoglobulin A nephropathy with diffuse membranoproliferative
glomerulonephritis CC
N02.B4 Recurrent and persistent immunoglobulin A nephropathy with diffuse membranous
glomerulonephritis CC
N02.B5 Recurrent and persistent immunoglobulin A nephropathy with diffuse mesangial proliferative
glomerulonephritis CC
N02.B6 Recurrent and persistent immunoglobulin A nephropathy with diffuse mesangiocapillary
glomerulonephritis CC
N02.B9 Other recurrent and persistent immunoglobulin A nephropathy CC
Chapter 14: Diseases of Genitourinary System
ICD-10-CM Code Additions, Deletions, and Revisions
40. © Health Catalyst. Confidential and Proprietary.
Additions
N04.20 Nephrotic syndrome with diffuse membranous glomerulonephritis, unspecified CC
N04.21 Primary membranous nephropathy with nephrotic syndrome CC
N04.22 Secondary membranous nephropathy with nephrotic syndrome CC
Code first, if applicable, other disease or disorder or poisoning causing membranous nephropathy
Use additional code, if applicable, for adverse effect of drug causing membranous nephropathy
N04.29 Other nephrotic syndrome with diffuse membranous glomerulonephritis CC
[Deletion: N04.2 Nephrotic syndrome with diffuse membranous glomerulonephritis]
Chapter 14: Diseases of Genitourinary System
ICD-10-CM Code Additions, Deletions, and Revisions
41. © Health Catalyst. Confidential and Proprietary.
Additions
N06.20 Isolated proteinuria with diffuse membranous glomerulonephritis, unspecified CC
N06.21 Primary membranous nephropathy with isolated proteinuria CC
N06.22 Secondary membranous nephropathy with isolated proteinuria CC
• Code first, if applicable, other disease or disorder or poisoning causing membranous
nephropathy
• Use additional code, if applicable, for adverse effect of drug causing membranous nephropathy
N06.29 Other isolated proteinuria with diffuse membranous glomerulonephritis CC
[Deletion: N06.2 Isolated proteinuria with diffuse membranous glomerulonephritis]
Chapter 14: Diseases of Genitourinary System
ICD-10-CM Code Additions, Deletions, and Revisions
42. © Health Catalyst. Confidential and Proprietary.
N35.812, Other urethral bulbous stricture, male
Revised to:
N35.812, Other bulbous urethral stricture, male
Chapter 14: Diseases of Genitourinary System
ICD-10-CM Code Additions, Deletions, and Revisions
43. © Health Catalyst. Confidential and Proprietary.
Additions
O26.641 Intrahepatic cholestasis of pregnancy, first trimester CC
O26.642 Intrahepatic cholestasis of pregnancy, second trimester CC
O26.643 Intrahepatic cholestasis of pregnancy, third trimester CC
O26.649 Intrahepatic cholestasis of pregnancy, unspecified trimester
O90.41 Hepatorenal syndrome following labor and delivery MCC
O90.49 Other postpartum acute kidney failure MCC
[Deletion: O90.4 Postpartum acute kidney failure]
Chapter 15: Pregnancy, Childbirth and the Puerperium
ICD-10-CM Code Additions, Deletions, and Revisions
44. © Health Catalyst. Confidential and Proprietary.
P19.9, Metabolic acidemia, unspecified
Revised to:
P19.9, Metabolic acidemia in newborn, unspecified
Chapter 16: Certain Conditions Originating in the Perinatal Period
ICD-10-CM Code Additions, Deletions, and Revisions
45. © Health Catalyst. Confidential and Proprietary.
Additions
Q44.70 Other congenital malformation of liver, unspecified CC
Q44.71 Alagille syndrome CC
Q44.79 Other congenital malformations of liver CC
[Deletion: Q44.7 Other congenital malformations of liver]
Chapter 17: Congenital Malformations, Deformations, and Chromosomal Abnormalities
ICD-10-CM Code Additions, Deletions, and Revisions
46. © Health Catalyst. Confidential and Proprietary.
Additions
Q75.001 Craniosynostosis unspecified, unilateral
Q75.002 Craniosynostosis unspecified, bilateral
Q75.009 Craniosynostosis unspecified
Q75.01 Sagittal craniosynostosis
Q75.021 Coronal craniosynostosis unilateral
Q75.022 Coronal craniosynostosis bilateral
Q75.029 Coronal craniosynostosis unspecified
Q75.03 Metopic craniosynostosis
[Deletion: Q75.0 Craniosynostosis]
Chapter 17: Congenital Malformations, Deformations, and Chromosomal Abnormalities
ICD-10-CM Code Additions, Deletions, and Revisions
47. © Health Catalyst. Confidential and Proprietary.
Additions
Q75.041 Lambdoid craniosynostosis, unilateral
Q75.042 Lambdoid craniosynostosis, bilateral
Q75.049 Lambdoid craniosynostosis, unspecified
Q75.058 Other multi-suture craniosynostosis
Q75.08 Other single-suture craniosynostosis
Q75.051 Cloverleaf skull
Q75.052 Pansynostosis
Q75.058 Other multi-suture craniosynostosis
Q75.08 Other single-suture craniosynostosis
Chapter 17: Congenital Malformations, Deformations, and Chromosomal Abnormalities
ICD-10-CM Code Additions, Deletions, and Revisions
48. © Health Catalyst. Confidential and Proprietary.
Additions
Q87.83 Bardet-Biedl syndrome CC
Q87.84 Laurence-Moon syndrome CC
Q87.85 MED13L syndrome CC
• Code also, if applicable, any associated manifestations such as: autism spectrum
disorder (F84.0-), congenital malformations of cardiac septa (Q21-), epilepsy and
recurrent seizures (G40.-), intellectual disability (F70-F79)
Q93.52 Phelan-McDermid syndrome CC
• Use additional code(s) to identify any associated conditions, such as: autism spectrum
disorder (F84.0), degree of intellectual disabilities (F70-F79), epilepsy and recurrent
seizures (G40.-), lyphedema (I89.0)
Chapter 17: Congenital Malformations, Deformations, and Chromosomal Abnormalities
ICD-10-CM Code Additions, Deletions, and Revisions
49. © Health Catalyst. Confidential and Proprietary.
Q85.81, PTEN tumor syndrome
Revised to:
Q85.81, PTEN hamartoma tumor syndrome
Q87.40, Marfan's syndrome, unspecified
Revised to:
Q87.40, Marfan syndrome, unspecified
Q87.410, Marfan's syndrome with aortic dilation
Revised to:
Q87.410, Marfan syndrome with aortic dilation
Chapter 17: Congenital Malformations, Deformations, and Chromosomal Abnormalities
ICD-10-CM Code Additions, Deletions, and Revisions
50. © Health Catalyst. Confidential and Proprietary.
Q87.418, Marfan's syndrome with other cardiovascular manifestations
Revised to:
Q87.418, Marfan syndrome with other cardiovascular manifestations
Q87.42, Marfan's syndrome with ocular manifestations
Revised to:
Q87.42, Marfan syndrome with ocular manifestations
Q87.43, Marfan's syndrome with skeletal manifestation
Revised to:
Q87.43, Marfan syndrome with skeletal manifestation
Chapter 17: Congenital Malformations, Deformations, and Chromosomal Abnormalities
ICD-10-CM Code Additions, Deletions, and Revisions
51. © Health Catalyst. Confidential and Proprietary.
Additions
R09.A0 Foreign body sensation, unspecified
R09.A1 Foreign body sensation, nose
R09.A2 Foreign body sensation, throat
R09.A9 Foreign body sensation, other site
R40.2A Nontraumatic coma due to underlying condition MCC
• Code first underlying condition
Chapter 18: Symptoms, Signs, and Abnormal Clinical and Laboratory Findings, Not Elsewhere Classified
ICD-10-CM Code Additions, Deletions, and Revisions
52. © Health Catalyst. Confidential and Proprietary.
Additions
R92.30 Dense breasts, unspecified
R92.311 Mammographic fatty tissue density, right breast
R92.312 Mammographic fatty tissue density, left breast
R92.313 Mammographic fatty tissue density, bilateral breasts
R92.321 Mammographic fibroglandular density, right breast
R92.322 Mammographic fibroglandular density, left breast
R92.323 Mammographic fibroglandular density, bilateral breasts
R92.331 Mammographic heterogeneous density, right breast
R92.332 Mammographic heterogeneous density, left breast
R92.333 Mammographic heterogeneous density, bilateral breasts
R92.341 Mammographic extreme density, right breast
R92.342 Mammographic extreme density, left breast
R92.343 Mammographic extreme density, bilateral breasts
Chapter 18: Symptoms, Signs, and Abnormal Clinical and Laboratory Findings, Not Elsewhere Classified
ICD-10-CM Code Additions, Deletions, and Revisions
53. © Health Catalyst. Confidential and Proprietary.
Additions
T56.821A Toxic effect of gadolinium, accidental (unintentional), initial encounter
T56.821D Toxic effect of gadolinium, accidental (unintentional), subsequent encounter
T56.821S Toxic effect of gadolinium, accidental (unintentional), sequela
T56.822A Toxic effect of gadolinium, intentional self-harm, initial encounter
T56.822D Toxic effect of gadolinium, intentional self-harm, subsequent encounter
T56.822S Toxic effect of gadolinium, intentional self-harm, sequela
T56.823A Toxic effect of gadolinium, assault, initial encounter
T56.823D Toxic effect of gadolinium, assault, subsequent encounter
T56.823S Toxic effect of gadolinium, assault, sequela
T56.824A Toxic effect of gadolinium, undetermined, initial encounter
T56.824D Toxic effect of gadolinium, undetermined, subsequent encounter
T56.824S Toxic effect of gadolinium, undetermined, sequela
Chapter 19: Injury, Poisoning, and Certain Other Consequences of External Causes
ICD-10-CM Code Additions, Deletions, and Revisions
54. © Health Catalyst. Confidential and Proprietary.
Additions
W44.8XXA Other foreign body entering into or through a natural orifice, initial encounter
W44.8XXD Other foreign body entering into or through a natural orifice, subsequent encounter
W44.8XXS Other foreign body entering into or through a natural orifice, sequela
W44.9XXA Unspecified foreign body entering into or through a natural orifice, initial encounter
W44.9XXD Unspecified foreign body entering into or through a natural orifice, subsequent encounter
W44.9XXS Unspecified foreign body entering into or through a natural orifice, sequela
W44.A0XA Battery unspecified, entering into or through a natural orifice, initial encounter
W44.A0XD Battery unspecified, entering into or through a natural orifice, subsequent encounter
W44.A0XS Battery unspecified, entering into or through a natural orifice, sequela
W44.A1XA Button battery entering into or through a natural orifice, initial encounter
W44.A1XD Button battery entering into or through a natural orifice, subsequent encounter
W44.A1XS Button battery entering into or through a natural orifice, sequela
Chapter 20: External Causes of Morbidity
ICD-10-CM Code Additions, Deletions, and Revisions
55. © Health Catalyst. Confidential and Proprietary.
Additions
W44.A9XA Other batteries entering into or through a natural orifice, initial encounter
W44.A9XD Other batteries entering into or through a natural orifice, subsequent encounter
W44.A9XS Other batteries entering into or through a natural orifice, sequela
W44.B0XA Plastic object unspecified, entering into or through a natural orifice, initial encounter
W44.B0XD Plastic object unspecified, entering into or through a natural orifice, subsequent encounter
W44.B0XS Plastic object unspecified, entering into or through a natural orifice, sequela
W44.B1XA Plastic bead entering into or through a natural orifice, initial encounter
W44.B1XD Plastic bead entering into or through a natural orifice, subsequent encounter
W44.B1XS Plastic bead entering into or through a natural orifice, sequela
W44.B2XA Plastic coin entering into or through a natural orifice, initial encounter
W44.B2XD Plastic coin entering into or through a natural orifice, subsequent encounter
W44.B2XS Plastic coin entering into or through a natural orifice, sequela
Chapter 20: External Causes of Morbidity
ICD-10-CM Code Additions, Deletions, and Revisions
56. © Health Catalyst. Confidential and Proprietary.
Additions
W44.B3XA Plastic toy and toy part entering into or through a natural orifice, initial encounter
W44.B3XD Plastic toy and toy part entering into or through a natural orifice, subsequent encounter
W44.B3XS Plastic toy and toy part entering into or through a natural orifice, sequela
W44.B4XA Plastic jewelry entering into or through a natural orifice, initial encounter
W44.B4XD Plastic jewelry entering into or through a natural orifice, subsequent encounter
W44.B4XS Plastic jewelry entering into or through a natural orifice, sequela
W44.B5XA Plastic bottle entering into or through a natural orifice, initial encounter
W44.B5XD Plastic bottle entering into or through a natural orifice, subsequent encounter
W44.B5XS Plastic bottle entering into or through a natural orifice, sequela
W44.B9XA Other plastic object entering into or through a natural orifice, initial encounter
W44.B9XD Other plastic object entering into or through a natural orifice, subsequent encounter
W44.B9XS Other plastic object entering into or through a natural orifice, sequela
Chapter 20: External Causes of Morbidity
ICD-10-CM Code Additions, Deletions, and Revisions
57. © Health Catalyst. Confidential and Proprietary.
Additions
W44.C0XA Glass unspecified, entering into or through a natural orifice, initial encounter
W44.C0XD Glass unspecified, entering into or through a natural orifice, subsequent encounter
W44.C0XS Glass unspecified, entering into or through a natural orifice, sequela
W44.C1XA Sharp glass entering into or through a natural orifice, initial encounter
W44.C1XD Sharp glass entering into or through a natural orifice, subsequent encounter
W44.C1XS Sharp glass entering into or through a natural orifice, sequela
W44.C2XA Intact glass entering into or through a natural orifice, initial encounter
W44.C2XD Intact glass entering into or through a natural orifice, subsequent encounter
W44.C2XS Intact glass entering into or through a natural orifice, sequela
W44.D0XA Magnetic metal object unspecified, entering into or through a natural orifice, initial encounter
W44.D0XD Magnetic metal object unspecified, entering into or through a natural orifice, subsequent encounter
W44.D0XS Magnetic metal object unspecified, entering into or through a natural orifice, sequela
Chapter 20: External Causes of Morbidity
ICD-10-CM Code Additions, Deletions, and Revisions
58. © Health Catalyst. Confidential and Proprietary.
Additions
W44.D1XA Magnetic metal bead entering into or through a natural orifice, initial encounter
W44.D1XD Magnetic metal bead entering into or through a natural orifice, subsequent encounter
W44.D1XS Magnetic metal bead entering into or through a natural orifice, sequela
W44.D2XA Magnetic metal coin entering into or through a natural orifice, initial encounter
W44.D2XD Magnetic metal coin entering into or through a natural orifice, subsequent encounter
W44.D2XS Magnetic metal coin entering into or through a natural orifice, sequela
W44.D3XA Magnetic metal toy entering into or through a natural orifice, initial encounter
W44.D3XD Magnetic metal toy entering into or through a natural orifice, subsequent encounter
W44.D3XS Magnetic metal toy entering into or through a natural orifice, sequela
W44.D4XA Magnetic metal jewelry entering into or through a natural orifice, initial encounter
W44.D4XD Magnetic metal jewelry entering into or through a natural orifice, subsequent encounter
W44.D4XS Magnetic metal jewelry entering into or through a natural orifice, sequela
Chapter 20: External Causes of Morbidity
ICD-10-CM Code Additions, Deletions, and Revisions
59. © Health Catalyst. Confidential and Proprietary.
Additions
W44.D9XA Other magnetic metal objects entering into or through a natural orifice, initial encounter
W44.D9XD Other magnetic metal objects entering into or through a natural orifice, subsequent encounter
W44.D9XS Other magnetic metal objects entering into or through a natural orifice, sequela
W44.E0XA Non-magnetic metal object unspecified, entering into or through a natural orifice, initial encounter
W44.E0XD Non-magnetic metal object unspecified, entering into or through a natural orifice, subsequent encounter
W44.E0XS Non-magnetic metal object unspecified, entering into or through a natural orifice, sequela
W44.E1XA Non-magnetic metal bead entering into or through a natural orifice, initial encounter
W44.E1XD Non-magnetic metal bead entering into or through a natural orifice, subsequent encounter
W44.E1XS Non-magnetic metal bead entering into or through a natural orifice, sequela
W44.E2XA Non-magnetic metal coin entering into or through a natural orifice, initial encounter
W44.E2XD Non-magnetic metal coin entering into or through a natural orifice, subsequent encounter
W44.E2XS Non-magnetic metal coin entering into or through a natural orifice, sequela
Chapter 20: External Causes of Morbidity
ICD-10-CM Code Additions, Deletions, and Revisions
60. © Health Catalyst. Confidential and Proprietary.
Additions
W44.E3XA Non-magnetic metal toy entering into or through a natural orifice, initial encounter
W44.E3XD Non-magnetic metal toy entering into or through a natural orifice, subsequent encounter
W44.E3XS Non-magnetic metal toy entering into or through a natural orifice, sequela
W44.E4XA Non-magnetic metal jewelry entering into or through a natural orifice, initial encounter
W44.E4XD Non-magnetic metal jewelry entering into or through a natural orifice, subsequent encounter
W44.E4XS Non-magnetic metal jewelry entering into or through a natural orifice, sequela
W44.E9XA Other non-magnetic metal objects entering into or through a natural orifice, initial encounter
W44.E9XD Other non-magnetic metal objects entering into or through a natural orifice, subsequent encounter
W44.E9XS Other non-magnetic metal objects entering into or through a natural orifice, sequela
W44.F0XA Objects of natural or organic material unspecified, entering into or through a natural orifice, initial encounter
W44.F0XD Objects of natural or organic material unspecified, entering into or through a natural orifice, subsequent encounter
W44.F0XS Objects of natural or organic material unspecified, entering into or through a natural orifice, sequela
Chapter 20: External Causes of Morbidity
ICD-10-CM Code Additions, Deletions, and Revisions
61. © Health Catalyst. Confidential and Proprietary.
Additions
W44.F1XA Bezoar entering into or through a natural orifice, initial encounter
W44.F1XD Bezoar entering into or through a natural orifice, subsequent encounter
W44.F1XS Bezoar entering into or through a natural orifice, sequela
W44.F2XA Rubber band entering into or through a natural orifice, initial encounter
W44.F2XD Rubber band entering into or through a natural orifice, subsequent encounter
W44.F2XS Rubber band entering into or through a natural orifice, sequela
W44.F3XA Food entering into or through a natural orifice, initial encounter
W44.F3XD Food entering into or through a natural orifice, subsequent encounter
W44.F3XS Food entering into or through a natural orifice, sequela
W44.F4XA Insect entering into or through a natural orifice, initial encounter
W44.F4XD Insect entering into or through a natural orifice, subsequent encounter
W44.F4XS Insect entering into or through a natural orifice, sequela
Chapter 20: External Causes of Morbidity
ICD-10-CM Code Additions, Deletions, and Revisions
62. © Health Catalyst. Confidential and Proprietary.
Additions
W44.F9XD Other object of natural or organic material, entering into or through a natural orifice, subsequent encounter
W44.F9XS Other object of natural or organic material, entering into or through a natural orifice, sequela
W44.G0XA Other non-organic objects unspecified, entering into or through a natural orifice, initial encounter
W44.G0XD Other non-organic objects unspecified, entering into or through a natural orifice, subsequent encounter
W44.G0XS Other non-organic objects unspecified, entering into or through a natural orifice, sequela
W44.G1XA Audio device entering into or through a natural orifice, initial encounter
W44.G1XD Audio device entering into or through a natural orifice, subsequent encounter
W44.G1XS Audio device entering into or through a natural orifice, sequela
W44.G2XA Combination metal and plastic toy and toy part entering into or through natural orifice, initial encounter
W44.G2XD Combination metal and plastic toy and toy part entering into or through natural orifice, subsequent encounter
W44.G2XS Combination metal and plastic toy and toy part entering into or through natural orifice, sequela
W44.G3XA Combination metal and plastic jewelry entering into or through a natural orifice, initial encounter
Chapter 20: External Causes of Morbidity
ICD-10-CM Code Additions, Deletions, and Revisions
63. © Health Catalyst. Confidential and Proprietary.
Additions
W44.G3XD Combination metal and plastic jewelry entering into or through a natural orifice, subsequent encounter
W44.G3XS Combination metal and plastic jewelry entering into or through a natural orifice, sequela
W44.G9XA Other non-organic objects entering into or through a natural orifice, initial encounter
W44.G9XD Other non-organic objects entering into or through a natural orifice, subsequent encounter
W44.G9XS Other non-organic objects entering into or through a natural orifice, sequela
W44.H0XA Other sharp object unspecified, entering into or through a natural orifice, initial encounter
W44.H0XD Other sharp object unspecified, entering into or through a natural orifice, subsequent encounter
W44.H0XS Other sharp object unspecified, entering into or through a natural orifice, sequela
W44.H1XA Needle entering into or through a natural orifice, initial encounter
W44.H1XD Needle entering into or through a natural orifice, subsequent encounter
W44.H1XS Needle entering into or through a natural orifice, sequela
W44.H2XA Knife, sword or dagger entering into or through a natural orifice, initial encounter
W44.H2XD Knife, sword or dagger entering into or through a natural orifice, subsequent encounter
W44.H2XS Knife, sword or dagger entering into or through a natural orifice, sequela
Chapter 20: External Causes of Morbidity
ICD-10-CM Code Additions, Deletions, and Revisions
64. © Health Catalyst. Confidential and Proprietary.
Additions
Z16.13 Resistance to carbapenem CC
Z22.340 Carrier of carbapenem-resistant Acinetobacter baumannii
Z22.341 Carrier of carbapenem-sensitive Acinetobacter baumannii
Z22.349 Carrier of Acinetobacter baumannii, unspecified
Z22.350 Carrier of carbapenem-resistant Enterobacterales
Z22.358 Carrier of other Enterobacterales
Z22.359 Carrier of Enterobacterales, unspecified
Z29.81 Encounter for HIV pre-exposure prophylaxis
• Code also, if applicable, risk factors for HIV, such as: contact with and (suspected) exposure to human immunodeficiency virus [HIV] (Z20.6) and
high risk sexual behavior (Z72.5-)
Z29.89 Encounter for other specified prophylactic measures
[Deletion: Z29.8 Encounter for other specified prophylactic measures]
Chapter 21: Factors Influencing Health Status and Contact with Health Services
ICD-10-CM Code Additions, Deletions, and Revisions
65. © Health Catalyst. Confidential and Proprietary.
Additions
Z02.84 Encounter for child welfare exam
Z62.23 Child in custody of non-parental relative
Z62.24 Child in custody of non-relative guardian
Z62.823 Parent-step child conflict
Z62.831 Non-parental relative-child conflict
Z62.832 Non-relative guardian-child conflict
Z62.833 Group home staff-child conflict
Z62.892 Runaway [from current living environment]
Chapter 21: Factors Influencing Health Status and Contact with Health Services
ICD-10-CM Code Additions, Deletions, and Revisions
66. © Health Catalyst. Confidential and Proprietary.
Additions
Z05.81 Observation and evaluation of newborn for suspected condition related to
home physiologic monitoring device ruled out
Z05.89 Observation and evaluation of newborn for other specified suspected condition
ruled out
[Deletion: Z05.8 Observation and evaluation of newborn for other specified suspected
condition ruled out]
Z91.85 Personal history of military service
• Excludes personal history of military deployment (Z91.82)
Chapter 21: Factors Influencing Health Status and Contact with Health Services
ICD-10-CM Code Additions, Deletions, and Revisions
67. © Health Catalyst. Confidential and Proprietary.
Additions
Z83.710 Family history of adenomatous and serrated polyps
Z83.711 Family history of hyperplastic colon polyps
Z83.718 Other family history of colon polyps
Z83.719 Family history of colon polyps, unspecified
[Deletion: Z83.71 Family history of colonic polyps]
Z91.A41 Caregiver's other noncompliance with patient's medication regimen due to financial hardship
Z91.A48 Caregiver's other noncompliance with patient's medication regimen for other reason
Z91.A51 Caregiver's noncompliance with patient's renal dialysis due to financial hardship
Z91.A58 Caregiver's noncompliance with patient's renal dialysis for other reason
Z91.A91 Caregiver's noncompliance with patient's other medical treatment and regimen due to financial hardship
Z91.A98 Caregiver's noncompliance with patient's other medical treatment and regimen for other reason
[Deletion: Z91.A4 Caregiver's other noncompliance with patient's medication regimen, Z91A5 Caregiver's noncompliance with patient's renal dialysis, and
Z91A9 Caregiver's noncompliance with patient's other medical treatment and regimen]
Chapter 21: Factors Influencing Health Status and Contact with Health Services
ICD-10-CM Code Additions, Deletions, and Revisions
69. © Health Catalyst. Confidential and Proprietary.
Guideline I.C.1.d.5 (b)- Infectious Diseases
ICD-10-CM Guideline Changes
70. © Health Catalyst. Confidential and Proprietary.
Guideline I.C.1.g.1 (f)- Infectious Disease
ICD-10-CM Guideline Changes
71. © Health Catalyst. Confidential and Proprietary.
Guideline I.C.2.t- Neoplasms
ICD-10-CM Guideline Changes
72. © Health Catalyst. Confidential and Proprietary.
Guideline I.C.9.a.12- New Guideline Regarding Resistant Hypertension
ICD-10-CM Guideline Changes
73. © Health Catalyst. Confidential and Proprietary.
Guideline I.C.9.e.6- New Guideline Regarding Coronary Microvascular Dysfunction
ICD-10-CM Guideline Changes
74. © Health Catalyst. Confidential and Proprietary.
Guideline I.C.18.e (1)- Symptoms
ICD-10-CM Guideline Changes
75. © Health Catalyst. Confidential and Proprietary.
Guideline I.C.18.i- Symptoms
ICD-10-CM Guideline Changes
76. © Health Catalyst. Confidential and Proprietary.
Guideline I.C.21.c.8- Z Codes
ICD-10-CM Guideline Changes
77. © Health Catalyst. Confidential and Proprietary.
Section III- Reporting Additional Diagnoses
ICD-10-CM Guideline Changes
79. © Health Catalyst. Confidential and Proprietary.
• Reassign ICD–10–CM diagnosis codes H34.10, H34.11, H34.12, H34.13, H34.231, H34.232,
H34.233, and H34.239 from MS–DRG 123 to MS–DRGs 124 and 125
• Designate the 10 ICD–10–PCS procedure codes describing the administration of a thrombolytic
agent as “non-O.R. procedures” that affect the MS–DRG
• Change the titles of MS–DRGs 124 and 125 from “Other Disorders of the Eye, with and without
MCC, respectively” to “Other Disorders of the Eye with MCC or Thrombolytic Agent, and without
MCC”
MDC 02 (Diseases and Disorders of the Eye): Retinal Artery Occlusion
MS-DRG Updates
80. © Health Catalyst. Confidential and Proprietary.
• Create new MS–DRG 173 (Ultrasound Accelerated and Other Thrombolysis with Principal
Diagnosis Pulmonary Embolism)
MDC 04 (Diseases and Disorders of the Respiratory System)
MS-DRG Updates
81. © Health Catalyst. Confidential and Proprietary.
• Create a new MS–DRG 212 (Concomitant Aortic and Mitral Valve Procedures)
• Reassign ICD–10–PCS code 02HA0RZ (Insertion of short-term external heart assist system into
heart, open approach) from MDC 05 in MS–DRG 215 to Pre-MDC MS–DRGs 001 and 002
when reported as a standalone procedure
• Create new MS–DRG 278 (Ultrasound Accelerated and Other Thrombolysis of Peripheral
Vascular Structures with MCC) and new MS–DRG 279 (Ultrasound Accelerated and Other
Thrombolysis of Peripheral Vascular Structures without MCC)
• Create new MS–DRG 323 (Coronary Intravascular Lithotripsy with Intraluminal Device with
MCC), new MS–DRG 324 (Coronary Intravascular Lithotripsy with Intraluminal Device without
MCC) and new MS–DRG 325 (Coronary Intravascular Lithotripsy without Intraluminal Device)
MDC 05 (Diseases and Disorders of the Circulatory System)
MS-DRG Updates
82. © Health Catalyst. Confidential and Proprietary.
• Delete MS–DRGs 246, 247, 248, and 249
• Create new MS–DRG 321 (Percutaneous Cardiovascular Procedures with Intraluminal Device with
MCC or 4+ Arteries/Intraluminal Devices) and new MS–DRG 322 (Percutaneous Cardiovascular
Procedures with Intraluminal Device without MCC)
• Reassign the procedure codes from current MS–DRGs 246, 247, 248, and 249 to the new MS–
DRGs 321 and 322.
• Revise the titles of MS–DRGs 250 and 251 from “Percutaneous Cardiovascular Procedures
without Coronary Artery Stent with MCC, and without MCC, respectively” to “Percutaneous
Cardiovascular Procedures without Intraluminal Device with MCC, and without MCC
MDC 05 (Diseases and Disorders of the Circulatory System)
MS-DRG Updates
83. © Health Catalyst. Confidential and Proprietary.
• Delete MS–DRGs 222, 223, 224, 225, 226, and 227
• Create new MS–DRG 275 (Cardiac Defibrillator Implant with Cardiac Catheterization and MCC), new MS–
DRG 276 (Cardiac Defibrillator Implant with MCC), and new MS–DRG 277 (Cardiac Defibrillator Implant
without MCC)
• Designate the procedure codes describing cardiac catheterization as non-O.R. procedures affecting the MS–
DRG.
• Designate ICD-10-PCS procedure codes 0T768DZ, 0T778DZ, and 0T788DZ reported with a principal diagnosis
of I10.0 from various MS-DRGs to MS-DRG 264.
• Designate the 28 ICD-10-PCS procedure codes describing the open excision of muscle with a principal
diagnosis of gangrene, not elsewhere classified (diagnosis code I96) to MS–DRG 264.
MDC 05 (Diseases and Disorders of the Circulatory System)
MS-DRG Updates
84. © Health Catalyst. Confidential and Proprietary.
• Delete MS–DRGs 338, 339, 340, 341, 342, and 343
• Create MS–DRGs 397, 398, and 399 (Appendix Procedures with MCC, with CC, and without
CC/MCC)
MDC 06 (Diseases and Disorders of the Digestive System): Appendicitis
MS-DRG Updates
85. © Health Catalyst. Confidential and Proprietary.
• Designate ICD–10–PCS procedure code 0NR00JZ, Replacement of skull with synthetic substitute,
open approach, to MDC 09. Cases reporting procedure code 0NR00JZ with a principal diagnosis in
MDC 09 (such as encounter for other plastic and reconstructive surgery following medical
procedure or healed injury) would group to MS–DRGs 579, 580, and 581 (Other Skin,
Subcutaneous Tissue and Breast Procedures with MCC, with CC, and without MCC/CC).
MDC 09- Diseases and Disorders of the Skin, Subcutaneous Tissue and Breast
MS-DRG Updates
86. © Health Catalyst. Confidential and Proprietary.
• Designate ICD–10–PCS procedure code 0DTN4ZZ, Resection of sigmoid colon, percutaneous
endoscopic approach, with a principal diagnosis of vesicointestinal fistula (diagnosis code N32.1),
to MS-DRGs 673, 674, and 675 (Other Kidney and Urinary Tract Procedures with MCC, with CC,
and without MCC/CC).
MDC 11- Diseases and Disorders of the Kidney and Urinary Tract
MS-DRG Updates
87. © Health Catalyst. Confidential and Proprietary.
• Redesignate the nine procedure codes that describe the occlusion of the splenic artery from
various MDCs to MDC 16 (Diseases and Disorders of Blood, Blood Forming Organs and
Immunologic Disorders) in MS–DRGs 799, 800, and 801 (Splenectomy with MCC, CC, and without
MCC/CC)
• Revise the titles of MDC 16 MS–DRGs 799, 800, and 801 from “Splenectomy with MCC, with CC,
and without CC/MCC, respectively” to “Splenic Procedures with MCC, with CC, and without
CC/MCC
MDC 16-Diseases and Disorders of Blood, Blood Forming Organs and Immunologic Disorders
MS-DRG Updates
88. © Health Catalyst. Confidential and Proprietary.
Resources
Hospital Inpatient Prospective Payment System (IPPS) Final Rule. Federal Register.
https://www.federalregister.gov/documents/2023/08/28/2023-16252/medicare-program-hospital-
inpatient-prospective-payment-systems-for-acute-care-hospitals-and-the
FY 2024 Code Updates: CM & PCS. Libman Education. https://libmaneducation.com/
Hospital-Acquired Conditions (HAC) Coding. CMS. https://www.cms.gov/medicare/payment/fee-for-
service-providers/hospital-aquired-conditions-hac/coding
FY 2024 IPPS Final Rule Home Page. CMS. https://www.cms.gov/medicare/payment/prospective-payment-
systems/acute-inpatient-pps/fy-2024-ipps-final-rule-home-page