ICD-10 2022 has a total of 72,748 codes, including 159 additions, 32 deletions, and 20 revisions. The new 2022 ICD-10 wound care codes that became effective on October 1, 2021 include codes for irritant contact dermatitis, anemia and blood disorders, thrombotic microangiopathy, and new Z codes. There are also additions and deletions to the MCC and CC lists, as well as changes to add-on payments. All of these updates will impact reporting of wound care encounters and vascular medical billing.

New 2022 ICD-10 Codes for Wound Care

The new wound care codes as listed in an article published in Today’s Wound Clinic are as follows:

  • Irritant Contact Dermatitis
    • L24A0 Irritant contact dermatitis due to friction or contact with body fluids, unspecified
    • L24A1 Irritant contact dermatitis due to saliva
    • L24A2Irritant contact dermatitis due to fecal, urinary or dualincontinence
    • L24A9Irritant contact dermatitis due friction or contact with otherspecified body fluids
    • L24B0Irritant contact dermatitis related to unspecified stoma orfistula
    • L24B1Irritant contact dermatitis related to digestive stoma orfistula
    • L24B2Irritant contact dermatitis related to respiratory stoma orfistula
    • L24B3Irritant contact dermatitis related to fecal or urinary stoma
  • Anemia and Blood Disorders
    • D55.21 Anemia due to pyruvate kinase deficiency
    • D55.29 Anemia due to other disorders of glycolytic enzymes
    • D75.838 Other thrombocytosis
    • D75.839 Thrombocytosis, unspecified
    • D89.44 Hereditary alpha tryptasemia
    • E752.44 Niemann-Pick disease type A/B
  • Thrombotic Microangiopathy/Other
    • F32A Depression, unspecified
    • M31.10 Thrombotic microangiopathy, unspecified
    • M31.11Hematopoietic stem cell transplantation-associatedthrombotic microangiopathy [HSCT-TMA]
    • M31.19 Other thrombotic microangiopathy
    • M35.06 Sjogren syndrome with peripheral nervous system involvement
    • M35.0B Sjogren syndrome with vasculitis
  • Z Codes
    • Z59.00 Homelessness unspecified
    • Z59.01 Sheltered homelessness
    • Z59.02 Unsheltered homelessness
    • Z55.5 Less than a high school diploma
    • Z58.6 Inadequate drinking-water supply
    • Z59.41 Food insecurity
    • Z59.48 Other specified lack of adequate food
    • Z59.8 Other problems related to housing and economic circumstances
    • Z59.811 Housing instability, housed, with risk of homelessness
    • Z59.812Housing instability, housed, homelessness in past 12months
    • Z59.819 Housing instability, housed unspecified
    • Z59.89 Other problems related to housing and economic circumstances
    • Z915 Personal history of self-harm
    • Z9151 Personal history of suicidal behavior
    • Z9152 Personal history of non-suicidal self-harm

Diagnostic assessment of the wound is essential to develop proper treatment plans for quick wound healing. Effective wound assessment requires good observation skills and current knowledge. In addition, proper documentation with the correct terminology is essential to ensure proper communication between members of the healthcare team. Physicians are also responsible for reporting services in accordance with their respective payer requirements.

All insurance companies including Medicare have policies regarding wound care. Practices should add the new ICD-10 codes applicable to wound care services to their billing systems and forms. All new coding guidelines should be reviewed with clinicians and billing staff. Wound management professionals should also review all relevant Medicare National Coverage Determinations (NCD) and Local Coverage Determinations (LCD) that have been updated due to the 2022 ICD-10 code changes. MCC and CC listings should be reviewed to identify wound management codes common to the practice and documented and coded correctly. The most specific ICD-10 code should be assigned and documentation should support the diagnosis code selected. Comprehensive wound care documentation is essential to support medical necessity, ensure patients receive the high-quality care and protect against litigation.

Errors in coding wound can attract auditor scrutiny, resulting in Additional Development Requests (ADRs) and denials. Physicians must confirm or clarify coding and coverage as each payer may have differing coding guidelines and coverage policies. Medical billing outsourcing is a practical option to overcome the challenges of reporting wound care encounters. An experienced company can help wound care clinics report services accurately and completely in accordance with ICD-10 and CPT guidelines and navigate the rules around billing and payment to maximize reimbursement for these services.