ICD 10 CM Official Updates and Changes - 2022 - Revised Codes

REVISED CODE EFFECTIVE FROM OCTOBER 1ST, 2021 TO SEPTEMBER 30, 2022

Code Description

F32 Depressive episode

G71.20 Congenital myopathy, unspecified

M35.00 Sjogren syndrome, unspecified

M35.01 Sjogren syndrome with keratoconjunctivitis

M35.02 Sjogren syndrome with lung involvement

M35.03 Sjogren syndrome with myopathy

M35.04 Sjogren syndrome with tubulo-interstitial nephropathy

M35.09 Sjogren syndrome with other organ involvement

T63.611A Toxic effect of contact with Portuguese Man-o-war, accidental (unintentional), initial encounter

T63.611D Toxic effect of contact with Portuguese Man-o-war, accidental (unintentional), subsequent encounter

T63.611S Toxic effect of contact with Portuguese Man-o-war, accidental (unintentional), sequela

T63.612A Toxic effect of contact with Portuguese Man-o-war, intentional self-harm, initial encounter

T63.612D Toxic effect of contact with Portuguese Man-o-war, intentional self-harm, subsequent encounter

T63.612S Toxic effect of contact with Portuguese Man-o-war, intentional self-harm, sequela

T63.613A Toxic effect of contact with Portuguese Man-o-war, assault, initial encounter

T63.613D Toxic effect of contact with Portuguese Man-o-war, assault, subsequent encounter

T63.613S Toxic effect of contact with Portuguese Man-o-war, assault, sequela

T63.614A Toxic effect of contact with Portuguese Man-o-war, undetermined, initial encounter

T63.614D Toxic effect of contact with Portuguese Man-o-war, undetermined, subsequent encounter

T63.614S Toxic effect of contact with Portuguese Man-o-war, undetermined, sequela

Z92.25 Personal history of immunosuppression therapy

See also Deleted Codes

Click Here to View New Codes

ICD 10 CM Official Updates and Changes - 2022 - Deleted Codes

DELETED CODE EFFECTIVE FROM OCTOBER 1ST, 2021 TO SEPTEMBER 30, 2022

Code Description

T40.7X1A Poisoning by cannabis (derivatives), accidental (unintentional), initial encounter

T40.7X1D Poisoning by cannabis (derivatives), accidental (unintentional), subsequent encounter

T40.7X1S Poisoning by cannabis (derivatives), accidental (unintentional), sequela

T40.7X2A Poisoning by cannabis (derivatives), intentional self-harm, initial encounter

T40.7X2D Poisoning by cannabis (derivatives), intentional self-harm, subsequent encounter

T40.7X2S Poisoning by cannabis (derivatives), intentional self-harm, sequela

T40.7X3A Poisoning by cannabis (derivatives), assault, initial encounter

T40.7X3D Poisoning by cannabis (derivatives), assault, subsequent encounter

T40.7X3S Poisoning by cannabis (derivatives), assault, sequela

T40.7X4A Poisoning by cannabis (derivatives), undetermined, initial encounter

T40.7X4D Poisoning by cannabis (derivatives), undetermined, subsequent encounter

T40.7X4S Poisoning by cannabis (derivatives), undetermined, sequela

T40.7X5A Adverse effect of cannabis (derivatives), initial encounter

T40.7X5D Adverse effect of cannabis (derivatives), subsequent encounter

T40.7X5S Adverse effect of cannabis (derivatives), sequela

T40.7X6A Underdosing of cannabis (derivatives), initial encounter

T40.7X6D Underdosing of cannabis (derivatives), subsequent encounter

T40.7X6S Underdosing of cannabis (derivatives), sequela

Return to view Revised Codes

See also New Codes

ICD 10 CM Official Updates and Changes - 2022 - New Codes

The 2022 ICD-10-CM files below contain information on the ICD-10-CM updates for FY 2022. These 2022 ICD-10-CM codes are to be used for discharges occurring from October 1, 2021, through September 30, 2022, and for patient encounters occurring from October 1, 2021, through September 30, 2022.

Total changes - 243

• New Codes  - 191 Additions
• Deleted Codes - 25 Deletions
• Revised Codes - 27 Revisions 

NEW CODE EFFECTIVE FROM OCTOBER 1ST, 2021 TO SEPTEMBER 30, 2022

Code Description

A79.82 Anaplasmosis [A. phagocytophilum]

C56.3 Malignant neoplasm of bilateral ovaries

C79.63 Secondary malignant neoplasm of bilateral ovaries

C84.7A Anaplastic large cell lymphoma, ALK-negative, breast

D55.21 Anemia due to pyruvate kinase deficiency

D55.29 Anemia due to other disorders of glycolytic enzymes

D75.83 Thrombocytosis

D75.838  Other thrombocytosis

D75.839  Thrombocytosis, unspecified

D89.44 Hereditary alpha tryptasemia

E75.244  Niemann-Pick disease type A/B

F32.A  Depression, unspecified

F78.A  Other genetic related intellectual disabilities

F78.A1 SYNGAP1-related intellectual disability

F78.A9 Other genetic related intellectual disability

G04.82 Acute flaccid myelitis

G44.86 Cervicogenic headache

G92.00 Immune effector cell-associated neurotoxicity syndrome, grade unspecified

G92.01 Immune effector cell-associated neurotoxicity syndrome, grade 1

G92.02 Immune effector cell-associated neurotoxicity syndrome, grade 2

G92.03 Immune effector cell-associated neurotoxicity syndrome, grade 3

G92.04 Immune effector cell-associated neurotoxicity syndrome, grade 4

G92.05 Immune effector cell-associated neurotoxicity syndrome, grade 5

G92.8 Other toxic encephalopathy

G92.9 Unspecified toxic encephalopathy

I5A       Non-ischemic myocardial injury (non-traumatic)

K22.81 Esophageal polyp

K22.82 Esophagogastric junction polyp

K22.89 Other specified disease of esophagus

K31.A0 Gastric intestinal metaplasia, unspecified

K31.A11  Gastric intestinal metaplasia without dysplasia, involving the antrum

K31.A12  Gastric intestinal metaplasia without dysplasia, involving the body (corpus)

K31.A13  Gastric intestinal metaplasia without dysplasia, involving the fundus

K31.A14  Gastric intestinal metaplasia without dysplasia, involving the cardia

K31.A15  Gastric intestinal metaplasia without dysplasia, involving multiple sites

K31.A19  Gastric intestinal metaplasia without dysplasia, unspecified site

K31.A21  Gastric intestinal metaplasia with low grade dysplasia

K31.A22  Gastric intestinal metaplasia with high grade dysplasia

K31.A29  Gastric intestinal metaplasia with dysplasia, unspecified

L24.A0 Irritant contact dermatitis due to friction or contact with body fluids, unspecified

L24.A1 Irritant contact dermatitis due to saliva

L24.A2 Irritant contact dermatitis due to fecal, urinary or dual incontinence

L24.A9 Irritant contact dermatitis due friction or contact with other specified body fluids

L24.B0 Irritant contact dermatitis related to unspecified stoma or fistula

L24.B1 Irritant contact dermatitis related to digestive stoma or fistula

L24.B2 Irritant contact dermatitis related to respiratory stoma or fistula

L24.B3 Irritant contact dermatitis related to fecal or urinary stoma or fistula

M31.10  Thrombotic microangiopathy, unspecified

M31.11  Hematopoietic stem cell transplantation-associated thrombotic microangiopathy [HSCT-TMA]

M31.19  Other thrombotic microangiopathy

M35.05  Sjogren syndrome with inflammatory arthritis

M35.06  Sjogren syndrome with peripheral nervous system involvement

M35.07  Sjogren syndrome with central nervous system involvement

M35.08  Sjogren syndrome with gastrointestinal involvement

M35.0A  Sjogren syndrome with glomerular disease

M35.0B  Sjogren syndrome with vasculitis

M35.0C  Sjogren syndrome with dental involvement

M45.A0  Non-radiographic axial spondyloarthritis of unspecified sites in spine

M45.A1  Non-radiographic axial spondyloarthritis of occipito-atlanto-axial region

M45.A2  Non-radiographic axial spondyloarthritis of cervical region

M45.A3  Non-radiographic axial spondyloarthritis of cervicothoracic region

M45.A4  Non-radiographic axial spondyloarthritis of thoracic region

M45.A5  Non-radiographic axial spondyloarthritis of thoracolumbar region

M45.A6  Non-radiographic axial spondyloarthritis of lumbar region

M45.A7  Non-radiographic axial spondyloarthritis of lumbosacral region

M45.A8  Non-radiographic axial spondyloarthritis of sacral and sacrococcygeal region

M45.AB  Non-radiographic axial spondyloarthritis of multiple sites in spine

M54.50  Low back pain, unspecified

M54.51  Vertebrogenic low back pain

M54.59  Other low back pain

P00.82 Newborn affected by (positive) maternal group B streptococcus (GBS) colonization

P09.1 Abnormal findings on neonatal screening for inborn errors of metabolism

P09.2 Abnormal findings on neonatal screening for congenital endocrine disease

P09.3 Abnormal findings on neonatal screening for congenital hematologic disorders

P09.4 Abnormal findings on neonatal screening for cystic fibrosis

P09.5 Abnormal findings on neonatal screening for critical congenital heart disease

P09.6 Abnormal findings on neonatal screening for neonatal hearing loss

P09.8 Other abnormal findings on neonatal screening

P09.9 Abnormal findings on neonatal screening, unspecified

R05.1 Acute cough

R05.2 Sub acute cough

R05.3 Chronic cough

R05.4 Cough syncope

R05.8 Other specified cough

R05.9 Cough, unspecified

R35.81 Nocturnal polyuria

R35.89 Other polyuria

R45.88 Non-suicidal self-harm

R63.30 Feeding difficulties, unspecified

R63.31 Pediatric feeding disorder, acute

R63.32 Pediatric feeding disorder, chronic

R63.39 Other feeding difficulties

R79.83 Abnormal findings of blood amino-acid level

S06.A0XA  Traumatic brain compression without herniation, initial encounter

S06.A0XD  Traumatic brain compression without herniation, subsequent encounter

S06.A0XS  Traumatic brain compression without herniation, sequela

S06.A1XA Traumatic brain compression with herniation, initial encounter

S06.A1XD Traumatic brain compression with herniation, subsequent encounter

S06.A1XS Traumatic brain compression with herniation, sequela

T40.711A Poisoning by cannabis, accidental (unintentional), initial encounter

T40.711D Poisoning by cannabis, accidental (unintentional), subsequent encounter

T40.711S Poisoning by cannabis, accidental (unintentional), sequela

T40.712A Poisoning by cannabis, intentional self-harm, initial encounter

T40.712D Poisoning by cannabis, intentional self-harm, subsequent encounter

T40.712S Poisoning by cannabis, intentional self-harm, sequela

T40.713A Poisoning by cannabis, assault, initial encounter

T40.713D Poisoning by cannabis, assault, subsequent encounter

T40.713S Poisoning by cannabis, assault, sequela

T40.714A Poisoning by cannabis, undetermined, initial encounter

T40.714D Poisoning by cannabis, undetermined, subsequent encounter

T40.714S Poisoning by cannabis, undetermined, sequela

T40.715A Adverse effect of cannabis, initial encounter

T40.715D Adverse effect of cannabis, subsequent encounter

T40.715S Adverse effect of cannabis, sequela

T40.716A Underdosing of cannabis, initial encounter

T40.716D Underdosing of cannabis, subsequent encounter

T40.716S Underdosing of cannabis, sequela

T40.721A Poisoning by synthetic cannabinoids, accidental (unintentional), initial encounter

T40.721D Poisoning by synthetic cannabinoids, accidental (unintentional), subsequent encounter

T40.721S Poisoning by synthetic cannabinoids, accidental (unintentional), sequela

T40.722A Poisoning by synthetic cannabinoids, intentional self-harm, initial encounter

T40.722D Poisoning by synthetic cannabinoids, intentional self-harm, subsequent encounter

T40.722S Poisoning by synthetic cannabinoids, intentional self-harm, sequela

T40.723A Poisoning by synthetic cannabinoids, assault, initial encounter

T40.723D Poisoning by synthetic cannabinoids, assault, subsequent encounter

T40.723S Poisoning by synthetic cannabinoids, assault, sequela

T40.724A Poisoning by synthetic cannabinoids, undetermined, initial encounter

T40.724D Poisoning by synthetic cannabinoids, undetermined, subsequent encounter

T40.724S Poisoning by synthetic cannabinoids, undetermined, sequela

T40.725A Adverse effect of synthetic cannabinoids, initial encounter

T40.725D Adverse effect of synthetic cannabinoids, subsequent encounter

T40.725S Adverse effect of synthetic cannabinoids, sequela

T40.726A Underdosing of synthetic cannabinoids, initial encounter

T40.726D Underdosing of synthetic cannabinoids, subsequent encounter

T40.726S Underdosing of synthetic cannabinoids, sequela

T80.82XA Complication of immune effector cellular therapy, initial encounter

T80.82XD Complication of immune effector cellular therapy, subsequent encounter

T80.82XS Complication of immune effector cellular therapy, sequela

U09.9  Post COVID-19 condition, unspecified

Y35.899A Legal intervention involving other specified means, unspecified person injured, initial encounter

Y35.899D Legal intervention involving other specified means, unspecified person injured, subsequent encounter

Y35.899S Legal intervention involving other specified means, unspecified person injured, sequela

Z55.5   Less than a high school diploma

Z58.6 Inadequate drinking-water supply

Z59.00 Homelessness unspecified

Z59.01 Sheltered homelessness

Z59.02 Unsheltered homelessness

Z59.41 Food insecurity

Z59.48 Other specified lack of adequate food

Z59.81 Housing instability, housed

Z59.811 Housing instability, housed, with risk of homelessness

Z59.812 Housing instability, housed, homelessness in past 12 months

Z59.819 Housing instability, housed unspecified

Z59.89 Other problems related to housing and economic circumstances

Z71.85 Encounter for immunization safety counseling

Z91.014 Allergy to mammalian meats

Z91.51 Personal history of suicidal behavior

Z91.52 Personal history of nonsuicidal self-harm

Z92.85 Personal history of cellular therapy

Z92.850 Personal history of Chimeric Antigen Receptor T-cell therapy

Z92.858 Personal history of other cellular therapy

Z92.859 Personal history of cellular therapy, unspecified

Z92.86 Personal history of gene therapy

Return to View Deleted Codes

Smoking Cessation Counselling

Smoking Cessation

The following codes are used to report the preventive medicine evaluation and management of infants, children, adolescents, and adults.

Modifier 25 should be added to the office/outpatient code to indicate that a significant, separately identifiable evaluation and management service was provided on the same day as the preventive medicine service. The appropriate preventive medicine service is additionally reported.

• 99406 – Smoking and tobacco-use cessation counseling visit; intermediate, greater than 3 minutes up to 10 minutes 
• 99407 – Smoking and tobacco-use cessation counseling visit; intensive, greater than 10 minutes 

Required Documentation

• Patient Current smoking details 
• Time 
• Counseling Content 

Covered ICD Codes 

• F17.210 - Nicotine dependence, cigarettes, uncomplicated

• F17.211 - Nicotine dependence, cigarettes, in remission

• F17.213 - Nicotine dependence, cigarettes, with withdrawal

• F17.218 - Nicotine dependence, cigarettes, with other nicotine-induced disorders

• F17.219 - Nicotine dependence, cigarettes, with unspecified nicotine-induced disorders

• F17.220 - Nicotine dependence, chewing tobacco, uncomplicated

• F17.221 - Nicotine dependence, chewing tobacco, in remission

• F17.223 - Nicotine dependence, chewing tobacco, with withdrawal

• F17.228 - Nicotine dependence, chewing tobacco, with other nicotine-induced disorders

• F17.229 - Nicotine dependence, chewing tobacco, with unspecified nicotine-induced disorders

• F17.290 - Nicotine dependence, other tobacco product, uncomplicated

• F17.291 - Nicotine dependence, other tobacco product, in remission

• F17.293 - Nicotine dependence, other tobacco product, with withdrawal

• F17.298 - Nicotine dependence, other tobacco product, with other nicotine-induced disorders

• F17.299 - Nicotine dependence, other tobacco product, with unspecified nicotine-induced disorders

Clinical Example

The patient confirms the use of tobacco products (specify the product). Smoking 4 cigarettes per day.  

Spent 10 minutes for counseling and patient education about the dangers of smoking, health risk, and education hand out given to the patients for awareness. 

Discussed in detail complications with treatment plan due to continued use of tobacco products. The patient listen carefully and accepted to stop smoking  

COVID-19 updates UnitedHealthcare

Temporary cost-share waivers extended to Oct. 17, 2021

The national public health emergency has been extended from July 19, 2021, to Oct. 17, 2021. Below is an overview of how that extension affects temporary provisions for COVID-19 testing and testing-related visits.

Individual Exchange, Individual and Group Market health plans: 

• From Feb. 4, 2020, through the national public health emergency period, United Healthcare is waiving cost-sharing for in-network and out-of-network COVID-19 tests and testing-related visits.

Medicare Advantage: 

• From Feb. 4, 2020, through the national public health emergency period, United Healthcare is waiving cost-sharing for in-network and out-of-network tests for COVID-19, including testing-related telehealth visits.

Medicaid: 

• State-specific rules and other state regulations may apply. For Medicaid and other state-specific regulations, please refer to your state-specific website or your state’s United Healthcare Community Plan website. 

CMS Unveils Surprise-Billing Rules

Proposed Billing Rules 2022

CMS unveiled July 2 the first in a series of rules aimed at shielding patients from surprise billing. The interim final rule addresses several provisions in the No Surprises Act passed by Congress last year.

Most provisions outlined in the proposed rule will not take effect until Jan. 1, 2022. 

Ten things to know,

1. Bans surprise billing for emergency services

• The interim final rule bans surprise billing for emergency services, regardless of where they are provided. 
• Providers are required to bill emergency services on an in-network basis without prior authorization.

2. Bans high out-of-network cost-sharing for emergency and non-emergency services 

• CMS proposed that patient cost-sharing, including coinsurance and deductibles, be based on in-network provider rates. 
• This means that cost-sharing can't be higher than if the services were provided by an in-network physician. 

3. Bans surprise billing for ancillary services and any "others." 

• The interim final rule prohibits out-of-network charges for ancillary care in in-network facilities in all instances. This includes anesthesiology services. 
• CMS said that it also includes a ban on any other out-of-network charges to patients without notice. 

4. Interim payment or notice of denial from insurers. 

• The interim final rule would require health plans to make an initial payment or issue a notice of denial to providers in 30 days after it receives a clean claim. 

5. Consent process to waive balance-billing protections. 

• The law allows patients to waive their balance-billing protections and consent to out-of-network charges. 
• The rule directs the departments to establish a process to obtain patient consent for balance billing. Providers can't use this for emergency services or some ancillary services.

6. Providers must disclose balance-billing protections. 

• Providers will be required to post publicly to inform patients about their surprise-billing protections.

7. Qualifying payment amount. 

• CMS defined the qualifying payment amount, which will calculate patient cost-sharing and be used by an arbiter in the independent dispute resolution process, as the issuer's median in-network rate for 2019 trended forward. 
• The rule addresses several factors that will determine how the rates are set, including the type of contract, insurance market, geographic region, and rates for the same or similar services. 

8. Complaint process. 

• Through the proposed rule, CMS will establish a process for which patients and others can submit complaints about violations of the balance-billing requirements. 

9. Arbitration process. 

• The first interim rule doesn't discuss the dispute resolution process. 

10. Comment period. 

• Providers will have 60 days to comment on the interim final rule.

ICD-10 CM Clinical Examples for Documentation

CLINICAL DOCUMENTATION

The providers need to be specifying the anatomical location and laterality in the documentation to select the appropriate most specific ICD codes. 

There are a few examples of clinical documentation updated below and how the physicians and clinicians communicate and what they pay attention to it is a matter of ensuring the information is captured in your documentation.

In ICD-10-CM, there are three main categories of changes,

• Definition Changes
• Terminology Differences
• Increased Specificity

The expansion of ICD-10 codes is due to the addition of laterality (left, right, bilateral). Physicians and other clinicians likely already note the side when evaluating the clinically pertinent anatomical site(s).

Clinical Examples:1 - ACUTE MYOCARDIAL INFARCTION (AMI)

When documenting an AMI, include the following,

Time-frame an AMI is now considered “acute” for 4 weeks from the time of the incident.

The episode of care ICD-10 does not capture an episode of care (e.g. initial, subsequent, sequelae).

Subsequent AMI ICD-10 allows coding of a new MI that occurs during the 4 weeks “acute period” of the original AMI.

• I21.02 ST elevation (STEMI) myocardial infarction involving left anterior descending coronary artery
• I21.4 Non-ST elevation (NSTEMI) myocardial infarction
• I22.1 Subsequent ST elevation (STEMI) myocardial infarction

Clinical Examples:2 - HYPERTENSION

In ICD-10, hypertension is defined as essential (primary). The concept of “benign or malignant” as it relates to hypertension no longer exists.

When documenting hypertension, include the following,

Types Hypertension - HTN, e.g. essential, secondary, etc.

Causal relationship e.g. Renal, pulmonary, etc.

• I10 Essential (primary) hypertension
• I11.9 Hypertensive heart disease without heart failure
• I15.0 Reno-vascular hypertension

Clinical Examples:3 - ASTHMA

ICD-10 terminology used to describe asthma has been updated to reflect the current clinical classification system.

When documenting asthma, include the following,

Cause Exercise-induced, cough variant, related to smoking, chemical or particulate cause, occupational.

Severity Choose one of the three options below for persistent asthma patients

• Mild persistent
• Moderate persistent
• Severe persistent

Temporal Factors Acute, chronic, intermittent, persistent, status asthmatics,  acute exacerbation,

• J45.30 Mild persistent asthma, uncomplicated
• J45.991 Cough variant asthma

Clinical Examples:4 - UNDER-DOSING

Underdosing is an important new concept and term in ICD-10. It allows you to identify when a patient is taking less of a medication than is prescribed.

When documenting underdosing, include the following,

Intentional, Unintentional, Non-compliance Is the underdosing deliberate? (e.g., patient refusal).

Reason Why is the patient not taking the medication? (e.g.financial hardship, age-related debility).

• Z91.120 Patient’s intentional underdosing of medication regimen due to  financial hardship
• T36.4x6A Underdosing of tetracyclines, initial encounter
• T45.526D Underdosing of antithrombotic drugs, subsequent encounter

Clinical Examples:5 - DIABETES MELLITUS, HYPOGLYCEMIA, AND HYPERGLYCEMIA

The diabetes mellitus codes are combination codes that include the type of diabetes mellitus, the body system affected, and the complications affecting that body system. When documenting diabetes, include the following,

Type e.g. Type 1 or Type 2 disease, drug or chemical induces, due to underlying condition, gestational.

Complications What (if any) other body systems are affected by the diabetes condition? e.g. Foot ulcer related to diabetes mellitus.

Treatment Is the patient on insulin?.

A second important change is the concept of “hypoglycemia” and “hyperglycemia.” It is now possible to document and code for these conditions without using “diabetes mellitus.”  The provider can also specify if the condition is due to a procedure or other cause.

The final important change is that the concept of “secondary diabetes Mellitus” is no longer used; instead, there are specific secondary options.

• E08.65 Diabetes Mellitus due to underlying condition with hyperglycemia
• E09.01 Drug or chemical induced diabetes Mellitus with  hyperosmolarity with coma
• R73.9 Transient post-procedural hyperglycemia
• R79.9 Hyperglycemia, unspecified

Clinical Examples:6  ABDOMINAL PAIN AND TENDERNESS

When documenting abdominal pain, including the following,

Location e.g. Generalized, Right upper quadrant, periumbilical, etc.

Pain or tenderness type e.g. Colic, tenderness, rebound

• R10.31 Right lower quadrant pain
• R10.32 Left lower quadrant pain
• R10.33 Periumbilical pain