Mastering the 2023 ICD-10-CM Updates PRESENTED BY: TONI ELHOMS, CCS, CPC, CPMA, CRC, AHIMA-APPROVED ICD-10-CM / PCS TRAINER 1
Toni Elhoms, CCS, CPC, CPMA, CRC, AHIMA Approved ICD-10-CM/PCS Trainer ❑ CEO – Alpha Coding Experts ❑ Podcast Host – Alpha Coding Podcast ❑ National Speaker - Coding, Compliance and Reimbursement SME ❑ Former President of Orlando, Florida AAPC Chapter ❑ Expert Witness ❑ Published Author ❑ Consultant/Educator/Trainer 2
Cover the the major ICD 10 CM updates for 2023
Review important ICD-10-CM code additions, deletions, and revisions for the 2023 Updates
Discuss guideline changes for 2023 ICD 10 CM updates
Spotlight the roles and workflows that may be impacted by the 2023 ICD 10 CM updates
Q&A at the end
Agenda
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2023 ICD-10-CM ❑ 1,176 New Codes ❑159 new codes in 2022 ❑ 251 Deleted Codes ❑ 36 Codes Converted to Parent Codes ❑ Significant guideline updates ❑ Coding updates have been released at a more frequent rate than in previous years 4
2023 ICD-10-CM ❑ Transition from FFS to VBC model continues to drive many coding changes ❑ New codes require a more complete documentation process with greater focus on code specificity that fully captures the acuity of the patient and the care provided ❑ VBC reimbursement model is contingent upon the quality of care provided 5
2023 ICD-10-CM Source: CMS 6
Guideline Updates ❑ I.B.14 – Underimmunization Status added to list of exceptions requiring provider documentation ❑ I.B.16 – Updated language in Documentation of Complications of Care ❑ I.C.1.a.2.a – Hemolytic uremic syndrome associated with HIV ❑ I.C.2a – Changes to admission/encounter for treatment of primary site for malignancy ❑ I.C.2.t. – Secondary malignant neoplasm of lymphoid tissue – new guideline ❑ I.C.5. d – Dementia – new guideline ❑ I.C. 15.a.7 – Completed weeks of gestation – new guideline ❑ I.C.15.q.4) – Hemorrhage following elective abortion – new guideline ❑ I.C.21.c.10 – Added paragraph for Z71 pediatric to adult transition ❑ I.C.21. 17 – Added information about the use of SDOH codes 7
2023 ICD-10-CM ❑ Major Updates pertain to: ❑ Candidiasis ❑ Hemolytic-uremic syndrome ❑ Von Willebrand Disease ❑ Thrombocytopenia ❑ Short stature ❑ Acidosis ❑ Dementia ❑ Endometriosis 8
2023 ICD-10-CM ❑ Major Updates pertain to: ❑ Aneurysms ❑ Intervertebral annulus fibrosus defect ❑ Muscle Wasting ❑ Epiphysis ❑ Pregnancy and Maternal Care ❑ Social Determinants of Health (SDoH) ❑ Long Term Drugs 9
2023 ICD-10-CM Source: Optum 360 10
Who is Impacted? Physicians/NPPs/ Other Healthcare Providers Nurses/Medical Assistants Scheduling/Prior Authorizations Revenue Cycle - Coders/Billers/Auditors Compliance Professionals EMR/PM Vendors 11
Workflows Impacted Clinical Documentation Templates/Forms Order Sets Prior Authorizations Medical Necessity Coding/Billing/Auditing Quality Measures 12
Best Practice Tips ❑ The days of only caring about CPT/HCPCS codes are numbered! ❑ Document based on presenting problems addressed at the encounter ❑ Select ICD-10-CM codes to the highest level of specificity ❑ Use Templates with caution ❑ Update as needed ❑ Copy/Forward edited for current presentation and encounter ❑ Avoid Cookie cutter documentation and overuse of MACROs 13
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