Typically, the largest update that is going to occur with ICD-10 codes happens in October of each year, and there were multiple changes this past October. April 1, 2023, there are going to be over 40 diagnosis codes added to the ICD-10 code set, many of them specific to Social Determinants of Health.   

Social Determinants of Health have really been a significant part of the recent CMS push to get more input on Social Determinants of Health which will affect risk adjustment and other items that might impact outcomes of healthcare entities. Going forward with that approach, they have added several diagnosis codes that will be available to be utilized in your coding. Remain aware that there are only 25 diagnosis codes spots available on your claims. If there is a push for 30 diagnoses on your patients and only 25 are going to be on claims, you need to ensure that the order of the diagnoses is such that any that would impact reimbursement are going to be reflected in the top 25. For many patients, 25 diagnoses are not a consideration, meaning that volume of diagnoses is not typically going to exist. However, on the patients that it does, you will want to ensure that the codes impacting reimbursement are in the first 25 that will be reported on the claim.   

You also need to ensure that your staff, especially your coding staff, becomes familiar with the ICD-10 codes that are being added effective April 1, 2023. They need to be familiar with these codes as the diagnosis title might be written by your field staff, physicians, or referral sources, and they will understand what those mean and ensure they are coded appropriately.  

Some of the categories may already have existed and they have simply expanded those with additional digits. It is always vitally important for ICD-10 coding that all diagnoses are coded to the greatest specificity possible. Always ensure that any diagnosis coded on your patient chart originated with an allowed practitioner that can diagnose patients.  

Correct coding directly impacts agency success. We are here to answer any questions you may have about your coding process and how Healthcare Provider Solutions can help. If you are seeking assistance with your coding, click here to schedule a one-on-one meeting with our Director of Coding & OASIS Review, Robbi D. Funderburk James, BSN, RN, HCS-D, HCS-O.