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.

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