ICD-10-CM Coding Updates 2022

The Centers for Medicare and Medicaid Services (CMS) officially released the fiscal year 2022 ICD-10-CM diagnosis code update on June 24, 2021. These coding updates are effective for discharges and encounters on or after October 1, 2021 through September 30, 2022. This update brings 159 additions, 25 deletions, and 27 revisions. ICD-10-CM codes for 2022 are to be used on claims from October 1, 2021 onwards. Being an experienced medical billing and coding company, we’re up to date with these changing code sets. An AAPC blog provides an overview of the coding updates, which include

CHAPTER 1 Certain Infectious and Parasitic Diseases (A00-B99)

• A79.82 Anaplasmosis [A. phagocytophilum]

CHAPTER 2 Neoplasms (C00-D49)

Added are two codes to capture bilateral ovarian malignancies, allowing classification as malignant or secondary malignant neoplasm. Another addition to the code set is

• C84.7A Anaplastic large cell lymphoma, ALK-negative, breast

CHAPTER 3 Diseases of the Blood and Blood-Forming Organs and Certain Disorders Involving the Immune Mechanism (D50-D89)

Five new codes are added to this chapter.

• D55.2 Anemia due to disorders of glycolytic enzymes
• D55.21 Anemia due to pyruvate kinase deficiency and
• D55.29 Anemia due to other disorders of glycolytic enzymes

Other changes include the addition of codes

• D75.83 Thrombocytosis
  • D75.838 Other thrombocytosis (including secondary and reactive) and
  • D75.839 Thrombocytosis, unspecified under new subcategory
• D89.44 Hereditary alpha tryptasemia

CHAPTER 4  Endocrine, Nutritional and Metabolic Diseases (E00-E89)

• E75.24 Niemann-Pick disease
  • E75.244 Niemann-Pick disease type A/B

CHAPTER 5  Mental, Behavioral and Neurodevelopmental Disorders (F01-F99)

• F32 Depressive episode
  • F32.A Depression, unspecified under revised category
• F78.A- Other genetic related intellectual disabilities
  • F78.A1 SYNGAP1-related intellectual disability
  • F78.A9 Other genetic related intellectual disability under new subcategory

CHAPTER 6  Diseases of the Nervous System (G00-G99)

10 new codes are added in this chapter:

• G04.82 Acute flaccid myelitis
• G44.86 Cervicogenic headache

Six codes are added under the new subcategory G92.0 to classify immune effector cell-associated neurotoxicity syndrome by grade.

• G92.0 Immune effector cell-associated neurotoxicity syndrome, grade unspecified
• G92.01 Immune effector cell-associated neurotoxicity syndrome, grade 1
• G92.02 Immune effector cell-associated neurotoxicity syndrome, grade 2
• G92.03 Immune effector cell-associated neurotoxicity syndrome, grade 3 (CC)
• G92.04 Immune effector cell-associated neurotoxicity syndrome, grade 4 (CC)
• G92.05 Immune effector cell-associated neurotoxicity syndrome, grade 5 (CC)

Two codes are added to distinguish other and unspecified toxic encephalopathy

• G92.8 Other toxic encephalopathy
• G92.9 Unspecified toxic encephalopathy

No changes are made in Chapter 7: Diseases of the Eye and Adnexa or Chapter 8: Diseases of the Ear and Mastoid Process (H60-H95)

CHAPTER 9  Diseases of the Circulatory System (I00-I99)

• I5A Non-ischemic myocardial injury (non-traumatic)

CHAPTER 11  Diseases of the Digestive System (K00-K95)

The digestive system includes the addition of 13 new codes within Chapter 11. This includes 10 codes for reporting of gastric intestinal metaplasia:

13 new codes have been added, which include 10 codes to report gastric intestinal metaplasia.

• K31.A0- Gastric intestinal metaplasia, unspecified
• K31.A11 Gastric intestinal metaplasia without dysplasia, involving the antrum
• K31.A12 Gastric intestinal metaplasia without dysplasia, involving the body (corpus)
• K31.A13 Gastric intestinal metaplasia without dysplasia, involving the fundus
• K31.A14 Gastric intestinal metaplasia without dysplasia, involving the cardia
• K31.A15 Gastric intestinal metaplasia without dysplasia, involving multiple sites
• K31.A19 Gastric intestinal metaplasia without dysplasia, unspecified site
• K31.A21 Gastric intestinal metaplasia with low grade dysplasia
• K31.A22 Gastric intestinal metaplasia with high grade dysplasia
• K31.A29 Gastric intestinal metaplasia with dysplasia, unspecified

Three new codes have been added to classify esophageal diseases:

• K22.81 Esophageal polyp
• K22.82 Esophagogastric junction polyp
• K22.89 Other specified disease of esophagus (hemorrhage of the esophagus NOS)

Coding tip – To determine the correct code among the new codes, coders need to check for documentation of the location involved and the presence of dysplasia.

CHAPTER 12 Diseases of the Skin and Subcutaneous Tissue (L00-L99)

Eight new codes are added under two new subcategories for irritant contact dermatitis:

• L24.A – Irritant contact dermatitis due to friction or contact with body fluids
  • L24.A0- Irritant contact dermatitis due to friction or contact with body fluids, unspecified
  • L24.A1 Irritant contact dermatitis due to saliva
  • L24.A2 Irritant contact dermatitis due to fecal, urinary or dual incontinence
  • L24.A9 Irritant contact dermatitis due to friction or contact with other specified body fluids
• L24.B- Irritant contact dermatitis related to stoma or fistula
  • L24.B0 – Irritant contact dermatitis related to unspecified stoma or fistula
  • L24.B1 – Irritant contact dermatitis related to digestive stoma or fistula
  • L24.B2 – Irritant contact dermatitis related to respiratory stoma or fistula
  • L24.B3 Irritant contact dermatitis related to fecal or urinary stoma or fistula

CHAPTER 13 Diseases of the Musculoskeletal System and Connective Tissue (M00-M99)

Three codes are added under subcategory M31.1 to report hematopoietic stem cell transplant-associated thrombotic microangiopathy.  The code set adds a Use Additional note after code M31.11, instructing you to also code for the specific organ dysfunction.

• M31.1 Thrombotic microangiopathy
  • M31.10 Thrombotic microangiopathy, unspecified
  • M31.11 Hematopoietic stem cell transplantation-associated thrombotic microangiopathy [HSCT-TMA]
  • M31.19 Other thrombotic microangiopathy

Several codes are added under revised subcategory

• M35.0 Sjogren syndrome (seven codes are added for identification of associated diseases or conditions)
  • M35.05 Sjogren syndrome with inflammatory arthritis
  • M35.06 Sjogren syndrome with peripheral nervous system involvement
  • M35.07 Sjogren syndrome with central nervous system involvement
  • M35.08 Sjogren syndrome with gastrointestinal involvement
  • M35.0A Sjogren syndrome with glomerular disease
  • M35.0B Sjogren syndrome with vasculitis
  • M35.0C Sjogren syndrome with dental involvement

New subcategory added is

• M45.A Non-radiographic axial spondyloarthritis

10 new codes are added for non-radiographic axial spondyloarthritis, which allows classification based on the affected region of the spine.

M54.5, the code for Low back pain is expanded with the addition of three codes

• M54.50 Low back pain, unspecified
• M54.51 Vertebrogenic low back pain, and
• M54.59 Other low back pain

CHAPTER 16 Certain Conditions Originating in the Perinatal Period (P00-P96)

Nine new codes are added –

• one code for newborn affected by maternal group B Streptococcus colonization and
• eight codes to capture specific abnormal findings on neonatal screening

CHAPTER 17  Congenital Malformations, Deformations and Chromosomal Abnormalities (Q00-Q99)

“Nephronopthisis” is revised to “Nephronophthisis” under code Q61.5 Medullary cystic kidney.

CHAPTER 18 Symptoms, Signs and Abnormal Clinical and Laboratory Findings, Not Elsewhere Classified (R00-R99)

14 codes are added to this Chapter.

Major additions include

• R45.88 Nonsuicidal self-harm, and
• R79.83 Abnormal findings of blood amino-acid level
• R63.30 Feeding difficulties, unspecified
• R63.31 Pediatric feeding disorder, acute
• R63.32 Pediatric feeding disorder, chronic
• R63.39 Other feeding difficulties (feeding problem (elderly) (infant) NOS, picky eater)

CHAPTER 19 Injury, Poisoning, and Certain Other Consequences of External Causes (S00-T88)

Six codes are added to differentiate traumatic brain compression with or without herniation under new subcategory –

• S06.A- Traumatic brain compression and herniation

36 new codes are added to classify poisoning, adverse effect, and underdosing of cannabis and synthetic cannabinoids under new subcategories –

• T40.71 Cannabis (derivatives), and
• T40.72 Synthetic cannabinoids

These codes replace deleted subcategory T40.7X- Cannabis (derivatives) and all of the codes classified under it.

CHAPTER 21 Factors Influencing Health Status and Contact with Health Services (Z00-Z99)

19 new codes are introduced and many updates are related to social determinants of health:

Code additions include

• Z55.5 Less than High School Diploma
• Z58.6 Inadequate drinking-water supply
• Z71.85 Encounter for immunization safety counseling
• Z91.014 Allergy to mammalian meats

Code expansions include

• Z59.0- Homelessness to allow specification of sheltered or unsheltered

Z59.4 Lack of food is expanded to include

• Z59.41 Food insecurity, and
• Z59.48 Other specified lack of adequate food

Three new codes are added under Z59.81 Housing instability, housed; and Z59.89 Other problems related to housing and economic circumstances to account for foreclosure on loan, isolated dwelling, and problems with creditors.

Four codes are added under Z92.8 Personal history of other medical treatment, three under new subcategory Z92.85 Personal history of cellular therapy, including chimeric antigen receptor T-Cell Therapy (CAR-T), and Z92.86 Personal history of gene therapy.

CHAPTER 22 Codes for Special Purposes (U00-U85)

One new code is added in this chapter.

• U09.9 Post COVID-19 condition, unspecified

Its Code first note instructs coders to list the code for the specific condition related to COVID-19, such as –

• J96.1- Chronic respiratory failure
• R43.8 Loss of smell or taste
• M35.81 Multisystem inflammatory syndrome

Assignment of accurate codes is critical for medical practices to submit clean claims and thus get reimbursement on time. Companies providing medical coding services can help practices meet such coding and billing challenges.