Mid-Year Coding Updates and A Quick Look at ICD-10-CM Changes

August 4th, 2022 - Aimee Wilcox
Categories:   Compliance   Practice Management  

For the past year, it has become commonplace for us to see updates to the various HCPCS, CPT, and ICD-10-CM codes due to the public health emergency (PHE). Historically, we have received the updated ICD codes a few months prior to their official implementation date of October 1st and the CPT codes a few months prior to their usual effective date of January 1st. HCPCS, however, in addition to its annual code updates that take effect on January 1st, also publishes quarterly updates, as needed."

July 2022 HCPCS Code Updates

This year HCPCS released a set of codes with an effective date of July 1, 2022. As you may recall, HCPCS codes are organized in to the following categories: 

  • A-codes:  Transportation, Medical & Surgical Supplies, Miscellaneous & Experimental
  • B-codes:  Enteral and Parenteral Therapy
  • C-codes:  Temporary Hospital Outpatient Prospective Payment System
  • D-codes:  Dental Procedures
  • E-codes:  Durable Medical Equipment
  • G-codes:  Temporary Procedures & Professional Services
  • H-codes:  Rehabilitative Services
  • J-codes:  Drugs Administered Other Than Oral Method, Chemotherapy Drugs
  • K-codes:  Temporary Codes for Durable Medical Equipment Regional Carriers
  • L-codes:  Orthotic/Prosthetic Procedures
  • M-codes:  Medical Services
  • P-codes:  Pathology and Laboratory
  • Q-codes: Temporary Codes
  • R-codes:  Diagnostic Radiology Services
  • S-codes:  Private Payer Codes
  • T-codes:  State Medicaid Agency Codes
  • V-codes:  Vision/Hearing Services

Some of the most commonly used codes are for Medicare and include G-codes representing professional services such as mammograms, colonoscopies, or telehealth services. G-codes are reported for Medicare beneficiaries or payers who publish policies stating they follow Medicare's guidelines for certain services instead of the CPT coding guidelines. J-codes for injectable drugs is another very commonly reported set of HCPCS codes. The bolded chapters in the list above are the areas where new HCPCS have become effective as of July 1, 2022.

For example, 

A9596 Gallium GA-68 Gozetotide, diagnostic, (Illuccix), 1 millicurie

This radioactive diagnostic agent is used with positron emission tomography (PET) scans to locate prostate-specific membrane antigen  (PSMA)-positive lesions, in men with prostate cancer. 

CPT Category III Code Updates

The American Medical Association (AMA) has released a list 11 CPT Category III code additions and two revised Category III codes along with their parenthetical notes, approved by the CPT Editorial Panel at the February and May 2022 meetings. Category III codes are temporary codes that hope to someday graduate to become CPT Category I codes, reported by providers nationwide.

ICD-10-CM Code Updates

CMS recently published the ICD-10-CM 2023 updates, which include 1,176 new codes, 28 revised codes, and 279 deleted codes. While this may appear to be a significant update, there are many code categories that include multiple anatomic sites, severity, or 7th character codes for initial, subsequent, or sequela, making up the majority of the newly added codes.

This year there were several new codes added to provide options for coding various types of bleeding disorders, one of which is Von Willebrand disease (VWD) that is represented by codes D68.0-. VWD is a hereditary bleeding disorder in which the individual has less than the needed amount of protein required to help blood cells stick together, form clots, and stop bleeding. There are three types of VWD, named after Dr. Von Willebrand, who discovered the disease.

  • Type 1 describes a mildly lower level than normal of the protein.
  • Type 2 is a malformation of the protein.
  • Type 3 is a severely lowered amount of the protein.

The acquired type of VWD is rare but indicates that either another disease or substance caused the patient's condition rather than it being hereditary.

Here are the new codes and their descriptions for this disease:

D68.0- Von Willebrand's disease

D68.00 Von Willebrand disease, unspecified
D68.01 Von Willebrand disease, type 1
D68.020 Von Willebrand disease, type 2A
   D68.021 Von Willebrand disease, type 2B
   D68.022 Von Willebrand disease, type 2M
   D68.023 Von Willebrand disease, type 2N
   D68.029 Von Willebrand disease, type 2, unspecified
D68.03  Von Willebrand disease, type 3
D68.04 Acquired Von Willebrand disease

Join us for a webinar where we will review these codes set updates in preparation for the upcoming changes. 

###

Questions, comments?

If you have questions or comments about this article please contact us.  Comments that provide additional related information may be added here by our Editors.


Latest articles:  (any category)

Artificial Intelligence in Healthcare - A Medical Coder's Perspective
December 26th, 2023 - Aimee Wilcox
We constantly hear how AI is creeping into every aspect of healthcare but what does that mean for medical coders and how can we better understand the language used in the codeset? Will AI take my place or will I learn with it and become an integral part of the process that uses AI to enhance my abilities? 
Specialization: Your Advantage as a Medical Coding Contractor
December 22nd, 2023 - Find-A-Code
Medical coding contractors offer a valuable service to healthcare providers who would rather outsource coding and billing rather than handling things in-house. Some contractors are better than others, but there is one thing they all have in common: the need to present some sort of value proposition in order to land new clients. As a contractor, your value proposition is the advantage you offer. And that advantage is specialization.
ICD-10-CM Coding of Chronic Obstructive Pulmonary Disease (COPD)
December 19th, 2023 - Aimee Wilcox
Chronic respiratory disease is on the top 10 chronic disease list published by the National Institutes of Health (NIH). Although it is a chronic condition, it may be stable for some time and then suddenly become exacerbated and even impacted by another acute respiratory illness, such as bronchitis, RSV, or COVID-19. Understanding the nuances associated with the condition and how to properly assign ICD-10-CM codes is beneficial.
Changes to COVID-19 Vaccines Strike Again
December 12th, 2023 - Aimee Wilcox
According to the FDA, CDC, and other alphabet soup entities, the old COVID-19 vaccines are no longer able to treat the variants experienced today so new vaccines have been given the emergency use authorization to take the place of the old vaccines. No sooner was the updated 2024 CPT codebook published when 50 of the codes in it were deleted, some of which were being newly added for 2024.
Updated ICD-10-CM Codes for Appendicitis
November 14th, 2023 - Aimee Wilcox
With approximately 250,000 cases of acute appendicitis diagnosed annually in the United States, coding updates were made to ensure high-specificity coding could be achieved when reporting these diagnoses. While appendicitis almost equally affects both men and women, the type of appendicitis varies, as dose the risk of infection, sepsis, and perforation.
COVID Vaccine Coding Changes as of November 1, 2023
October 26th, 2023 - Wyn Staheli
COVID vaccine changes due to the end of the PHE as of November 1, 2023 are addressed in this article.
Medicare Guidance Changes for E/M Services
October 11th, 2023 - Wyn Staheli
2023 brought quite a few changes to Evaluation and management (E/M) services. The significant revisions as noted in the CPT codebook were welcome changes to bring other E/M services more in line with the changes that took place with Office or Other Outpatient Services a few years ago. As part of CMS’ Medicare Learning Network, the “Evaluation and Management Services Guide” publication was finally updated as of August 2023 to include the changes that took place in 2023. If you take a look at the new publication (see references below),....



Home About Terms Privacy

innoviHealth® - 62 E 300 North, Spanish Fork, UT 84660 - Phone 801-770-4203 (9-5 Mountain)

Copyright © 2000-2024 innoviHealth Systems®, Inc. - CPT® copyright American Medical Association