ICD-10 Updates

Earlier this summer, the Centers for Medicare & Medicaid Services (CMS) released the ICD-10-CM code descriptions, tables and index, and addendum for the fiscal year 2022.

Then on July 12th, the Official Guidelines for Coding and Reporting of ICD-10-CM became available online. The updated manual and guidelines for FY 2022 revealed 159 new codes, along with the Tabular and Index Addenda. Below is a summary of the changes that will most affect the Skilled Nursing Facilities (SNF) in the upcoming year:

  • 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
  • D89.44 Hereditary alpha tryptasemia
  • F32.A Depression, unspecified under revised category F32 Depressive episode
  • F78.A9 Other genetic related intellectual disabilities under a new subcategory
  • F78.A- Other genetic-related intellectual disabilities.
  • I5A Non-ischemic myocardial injury (non-traumatic)
  • I20-I25 Ischemic, now requires an appropriate HTN code
  • Under L24.A- Irritant contact dermatitis due to friction or contact with body fluids, adds four new codes to identify the fluid type
  • Under L24.B- Irritant contact dermatitis related to stoma or fistula adds four new codes to enable specification of the type of stoma or fistula. For example, digestive, respiratory, fecal/urinary
  • New subcategory M45.A Non-radiographic axial spondyloarthritis and ten codes for non-radiographic axial spondyloarthritis
  • M54.50 Low back pain, unspecified
  • M54.51 Vertebrogenic low back pain
  • M54.59 Other low back pain.
  • R05 is not a reportable code in the 2022 code set. Instead, there are six new codes for cough with greater specificity
  • The addition of two codes to differentiate between nocturnal polyuria and polyuria is not otherwise specified (NOS)
  • R45.88 Non-suicidal self-harm
  • R79.83 Abnormal findings of blood amino-acid level
  • R63.30 Feeding difficulties, unspecified
  • R63.39 Other feeding difficulties (feeding problem (elderly) (infant) NOS, picky eater)

Coding Conventions

In addition to the above ICD-10 codes, changes and clarifications are also made to the coding conventions. Here is a quick summary of the changes that will affect Skilled Nursing Facilities. For detail on these changes, please refer to the Official Guidelines for Coding.

  • Additional instructions are added for situations when the patient’s provider does not document laterality. Code assignment for the affected side can be based on medical record documentation from other clinicians.
  • Documentation by Clinicians Other than the Patient’s Provider has expanded the exceptions. These exceptions now include codes for non-pressure chronic ulcers, social determinants of health (SDOH), laterality, and blood alcohol level.
  • New “post-COVID-19” guidance, including the assignment of code U09.9, Post COVID-19 condition, unspecified.

Explore More Posts from MDS Consultants

Reimbursement Concerns

Maximizing Case Mix with Special Programs: Respiratory Therapy and Restorative Nursing

Case mix is essential in skilled nursing facilities as it impacts both reimbursement and the care provided. Two key programs that significantly impact case mix scores when properly implemented and documented are Respiratory Therapy and Restorative Nursing. Both...

Strategic Admissions: The Path to Optimized Medicaid Reimbursement

Medicaid reimbursement plays a significant role in the financial health of long-term care facilities, particularly those serving a high percentage of Medicaid residents. While it may not be the sole source of revenue, it is an important component that supports the...

Interim Payment Assessment (IPA) – To do or not to do?

The Patient-Driven Payment Model took effect in October of 2019. Along with this change came the optional IPA. We are now five years into this change and questions still arise on when to complete an IPA. The decision of when to complete lies with the team at the...

Resident Interviews – What are you doing to capture the data?

Effective October 1, 2023, several resident interviews were added to or updated on the MDS. Interview items in Section A and changes to the interviews in Section D, J, and Q have been implemented. Each of the interviews can be a great steppingstone in your path to...

Social Determinants of Health (SDOH) – A Global Initiative Important to Skilled Nursing Providers

The Centers for Medicare & Medicaid Services’ (CMS) Office of Mental Health report CMS Framework for Health Equity 2022 and 2032 states that health equity is defined by the attainment of the highest level of health for all people, where everyone has a fair and...

Read more on Toolbox Essentials

Focused Infection Control Surveys and Directed Plan of Correction

It's a dreary Monday morning, and the state surveyors walk into your facility to conduct a Focused Infection Control survey. You and your team have been trying your hardest to comply with infection control procedures throughout the pandemic. At the end of the survey,...

New Advanced Beneficiary Notice

Is your facility using the proper ABN form? The Centers for Medicare & Medicaid Services (CMS) recently updated the Advanced Beneficiary Notice of Noncoverage (ABN), Form CMS-R-131. The new ABN will be mandatory for use on 1/1/2021, but the new form can be...

Covid-19 and Skilled Status

In late June, CMS addressed two issues and posted MDS 3.0 Final Item Sets (V1.17.2).  The two edits were changes to facilitate the calculation of Patient-Driven Payment Model payment codes on OBRA assessments for states that wish to have this calculation performed. ...

Mind Your PHQs

Some skilled nursing facilities (SNFs) are concerned about accurate payment when a resident unexpectedly discharges and the Brief Interview for Mental Status (BIMS) has not yet been completed.However, they should be just as concerned about the PHQ-9. The PHQ-9...

MDS in the Emergency Preparedness Plan

The COVID-19 pandemic has highlighted the need for skilled nursing facilities to have an effective Emergency Preparedness Plan - one that includes sheltering-in-place. The Centers for Medicare and Medicaid Final Rule requires that participating providers have an...

MORE from MDS Experts

Internet Quality Improvement and Evaluation System (iQIES): A New Age

Just when we thought we had a handle on QIES (Quality Improvement and Evaluation System), the Centers for Medicare & Medicaid Services (CMS) transitioned to the Internet Quality Improvement and Evaluation System (iQIES) in 2023.   Reports and Roles Reports...

A Significant Change in Status Assessment – There are Options

The Resident Assessment Instrument (RAI) system includes a significant change in status assessment (SCSA). What might be forgotten is the State Operation Manual (SOM), Appendix PP, includes information that mirrors the RAI manual at 42 CFR §483.20(b)(2)(ii), F637 -...

Interim Payment Assessment (IPA) – To do or not to do?

The Patient-Driven Payment Model took effect in October of 2019. Along with this change came the optional IPA. We are now five years into this change and questions still arise on when to complete an IPA. The decision of when to complete lies with the team at the...

Resident Interviews – What are you doing to capture the data?

Effective October 1, 2023, several resident interviews were added to or updated on the MDS. Interview items in Section A and changes to the interviews in Section D, J, and Q have been implemented. Each of the interviews can be a great steppingstone in your path to...

Section GG Documentation – Questions Still Abound

Section GG remains a popular discussion topic among the Nurse Assessment Coordinator (NAC) and other members of the interdisciplinary team (IDT). Many have questioned their own practices and processes, designed to support coding this section of the MDS. CMS states in...