News: New ICD-10-CM/PCS diagnosis and procedure codes in effect April 1, big focus on SDOH

Both the CDC and CMS have implemented coding changes effective April 1, 2023.

CMS implemented 34 new ICD-10-PCS procedure codes in their quarterly update. In the CDC’s ICD-10-CM diagnosis code changes, 43 new diagnosis codes were added, seven deleted, and one revised, with the new codes placing an emphasis on social determinants of health (SDOH). One new SDOH code reports problems related to education and literacy, for instance. To support these additions, the ICD-10-CM Official Guidelines for Coding and Reporting now includes more examples in the SDOH section, HealthLeaders reported.

Other codes added have updated the verbiage of external abuse codes to reflect current CDC core data collection elements and literature. Several new codes pertain to financial abuse, including a code for adult financial abuse, confirmed, initial encounter, and a code for child financial abuse, confirmed, initial encounter.

These updates reflect the increasing emphasis on SDOH, with quality requirements under the SDOH health measure becoming mandatory in 2024. With reporting falling under a payment determination in 2026, more changes are likely to be seen in preparation for the upcoming change. With nearly 80% of healthcare organizations collecting SDOH data but many reporting challenges, organizations and their revenue cycle leaders will benefit from following these updates closely and testing out workflows now.

Editor’s note: To read HealthLeaders’ coverage of this story, click here. To read the ICD-10-CM code changes, click here. To access CMS’s quarterly update, click here. To read more about the importance of SDOH codes, read this article from the July/August 2022 edition of the CDI Journal.