The 2024 ICD-10-CM coding updates, which will bring significant changes impacting home health, are set to take effect on October 1, 2023. It is important for home health agencies and their coders to thoroughly understand the changes and address their impact on coding processes.
Below are some notable changes we think have significant impact on home health coding:
Chapter 6: Diseases of the Nervous System (G00-G99)
The final update confirms the introduction of five new codes for Parkinson’s disease:
- 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).
Chapter 13: Diseases of the Musculoskeletal System and Connective Tissue (M00-M99)
This contains 42 new codes to help further define osteoporosis with pathological fracture. Some examples:
- M80.8B2P (Other osteoporosis with current pathological fracture, left pelvis, subsequent encounter for fracture with malunion)
- M80.8B9D (Other osteoporosis with current pathological fracture, unspecified pelvis, subsequent encounter for fracture with routine healing)
- M80.0B1K (Age-related osteoporosis with current pathological fracture, right pelvis, subsequent encounter for fracture with nonunion)
- M80.0B2G (Age-related osteoporosis with current pathological fracture, left pelvis, subsequent encounter for fracture with delayed healing)
The addition of osteoporosis with current pathological fractures of the pelvis is something that has been lacking in the code set and will help provide greater specificity on the fracture location.
Chapter 21: Factors Influencing health status and contact with Health Services (Z00-Z99)
The update contains several changes that impact Social Determinants of Health (SDoH). Here’s a concise overview:
- Introduction of new code Z29.81 for HIV pre-exposure prophylaxis encounters
- A ‘code also’ note for reporting HIV risk factors, when applicable, using codes such as Z20.6 (Contact with and [suspected] exposure to human immunodeficiency virus [HIV]) and Z72.5– (High-risk sexual behavior).
- Extensive ‘code also’ update for Z62.8 (Other specified problems related to upbringing) adds the following to the list of codes that should also be reported when applicable:
- Z63.3 (Absence of a family member)
- Z63.4 (Disappearance and death of family member)
- Z63.5 (Disruption of family by separation and divorce)
- Z63.8 (Other specified problems related to primary support group)
- Z63.7 (Other stressful life events affecting family and household)
- Introduction of new code Z91.85 (Personal history of military service) as an ‘Excludes2’ code for Z91.82 (Personal history of military deployment).
- Z91.85 also has the clarification of terms “personal history of serving in the armed forces” and “personal history of veteran”.
Applying the Updates Effectively
Coders in home health agencies must learn to use these coding updates effectively. It is important that coders are familiar with the new codes and changes in reporting requirements for specific conditions to ensure accurate billing and compliance. By staying updated, home health agencies can maintain coding accuracy and promote patient-centric care.
Additionally, agencies should educate their referral sources about the upcoming changes. This will allow them to start documenting more specific information in advance, reducing queries when the updates come into effect in October.
See full list of coding changes from CDC here>
Access the ICD-10-CM Official Guidelines for Coding and Reporting by CMS here>