Planning and Preparing for Coding Updates . . . Key Steps

Gloryanne Bryant, RHIA, CDIP, CCS, CCDS, AHIMA Approved ICD-10-CM/PCS Trainer Medical Coding Leave a Comment

Planning and Preparing for Coding Updates . . . Key Steps

The Centers for Medicare and Medicaid Services (CMS) released their proposed Fiscal Year 2023 ICD-10-CM coding update and the final ICD-10-PCS codes changes. The ICD-10-CM proposal has some significant changes and new codes. The ICD-10-CM does have a high volume of new code to absorb and learn about. The ICD-10-PCS is always of interest with new procedure and devices being developed and used in medicine and the Centers for Medicare and Medicaid has the FY2023 files available now. The time is now to start your FY2023 ICD-10-CM/PCS learning!

Planning and preparing for the fiscal year (FY) 2023 ICD-10-CM/PCS coding update takes time and effort, so anticipate this as it will serve you and your staff well in doing so. The ICD-10-CM “proposed” coding update was released by the Centers for Medicare and this “proposed coding update” contains 1,176 new codes for FY2023. There are some key aspects to the planning and preparing for the coding updates; changes/revisions, deletions and new guidelines and/or codes. Note that the “final” FY 2023 ICD-10-CM coding update should be published in late June or July, so stay tuned for that.

Start your preparations now by looking carefully for changes or revisions, deletions and then of course the new ICD-10-CM codes. Review these changes chapter by chapter. Keep in mind that the basics and foundation of ICD-10-CM classification system has several key components which are vital to learning and applying any coding updates:

  • Official Guidelines for Coding and Reporting
  • Alphabetic Index to Diseases and Injuries (Alphabetic Index)
  • Table of Neoplasms
  • Table of Drugs and Chemicals
  • External Cause of Injuries Index
  • Tabular List of Diseases and Injuries (Tabular List)

ICD-10-CM Guidelines: When planning and preparing for the FY2023 you will want to check on any changes, revisions, deleted or new guidelines. Sometimes there are editorial changes that take place, in addition to new guidelines or deleted language.

ICD-10-CM Alphabetic Index: The alphabetic index contains a very long list of terms which are laid out from A-Z. Per coding conventions, the alphabetic index is the first place for coding professionals to look-up and/or check on a diagnostic term or condition. However, we of course do not select the final code from the alphabetic index alone.

ICD-10-CM Tabular List: The tabular list has a format that is chapter specific in structure. In addition, there will be chapter specific guidelines at the beginning of the chapter which apply to all the codes within the chapter unless otherwise instructed. I really enjoy reviewing the “tabular” and it’s specific details, even the “NEC” Not elsewhere classifiable and “NOS” Not otherwise specified convention can really change the selection of an ICD-10-CM code, so always review the instructional notes also.

While conducting a review or an educational presentation on the ICD-10-CM tabular changes, focus also on key documentation terminology and possible challenges, as these will be important to identify and bring to the attention of both coding and Clinical Documentation Improvement (CDI) staff.

For procedural coding on the hospital inpatient setting, we use the ICD-10-PCS. And here too we have specific guidelines that must be used and followed. The FY2023 update has been finalized and includes 331 new codes, and 64 codes are deleted.

ICD-10-PCS Guidelines: There is a new guideline B3.19 for detachment procedures of extremities and revised general guidelines at B4.1c (Body Part) and B6.1a (Device).

ICD-10-PCS Tables: The CMS ICD-10-PCS table files can be very helpful when learning about the new and changed codes. Look closely at the terminology used in the tables as this might also be helpful when reading the clinical documentation in the medical record.

Education and auditing will be a key aspect to your coding accuracy and compliance efforts. The “final” ICD-10-PCS files have been released and the PCS codes are to be used for discharges occurring from October 1, 2022, through September 30, 2023. Visit the CMS website for additional information and CMS files. 

Digest information and seek questions and clarifications is always good to plan for, so bring together your coding staff for a “coding huddle” prior to October 1st, 2022, to ensure there is a strong understanding of the changes.

In addition to the steps and areas above, researching and reading up on the diseases, conditions and the surgical procedures is something you’ll want to do to enhance your clinical knowledge. There is often some very interesting aspects to the medical statistics, sign/symptoms and the treatment for the diagnoses and procedures.

It’s an imperative to include both education and auditing as a large component of your coding compliance planning and preparations for FY2023. As I mentioned at the beginning of this blog, time and effort is needed to thoroughly and completed plan and prepare for the FY2023 ICD-10-CM/PCS coding update.

MRA is available to provide assistance in consulting as well as for auditing and education. To learn more, visit:

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