ICD-10-CM 2024 Updates

Pushpa Perumal, CPC

 Disclaimer

This material is designed to offer basic information for coding

and billing. The information presented here is based on the
experience, training and interpretation of the author. Although
the information has been carefully researched and checked for
accuracy and completeness, the instructor does not accept any
responsibility or liability with regard to errors, omissions, misuse
or misinterpretation. This handout is intended as an educational
guide and should not be considered a legal/consulting opinion.
 Learning Objectives
❖Overview of ICD-10-CM 2024 Updates
❖Highlights of ICD-10-CM 2024 Updates
❖Summary of ICD 10 CM 2024 Coding Updates
❖Distribution of Codes
❖Understand Guidelines revision in 2024
❖Chapter wise new codes details
 Highlights of 2024 ICD-10-CM Updates
❖New Sepsis Codes
❖Screening for Covid 19
❖Acute Myocardial Infarction
❖Parkinson's Disease
❖Short Bowel Syndrome
❖Hepatorenal Syndrome following Labor an delivery
❖Alagille Syndrome
❖Craniosynostosis
❖Coma with Traumatic brain injury codes
❖External Cause
 Summary of 2024 ICD-10-CM Codes Updates
CMS has provided ICD-10-CM Coding updates for the fiscal year
beginning Oct 1 2023, and ending Sep 30 2024
ICD-10-CM chapter New Revised Invalid/Deleted
Total 395 13 25
 Distributions of Codes
Description Additions Deletions Changes
Infectious & Parasitic Diseases (A/B 1 0 0
Neoplasms (C/D) 21 2 0
Diseases of Blood and Blood Forming Organs (D) 0 0 0
Diseases of Endocrine System (E) 18 0 0
Mental, Behavioral, & Neurodevelopmental Disorders (F) 0 0 0
Diseases of Nervous System (G) 24 2 0
Diseases of Eye and Adnexa (H) 34 1 0
Diseases of Ear and Mastoid Process (H) 0 0 0
Diseases of the Circulatory System (I) 10 3 0
Diseases of the Respiratory System (J) 7 1 0
Diseases of the Digestive System (K) 17 2 0
Diseases of Skin and Subcutaneous Tissue (L) 0 0 0
Diseases of Musculoskeletal System and Connective Tissue (M) 36 0 0
Diseases of Genitourinary System (N) 15 2 1
Childbirth, Pregnancy, & Puerperium (O) 6 1 0
Conditions Originating in the Perinatal Period (P) 0 0 1
Congenital Malformations, Deformations, and Chromosomal Abnormalities (Q) 22 2 6
Signs & Symptoms (R) 18 0 0
Injury and Poisoning (S &T) 12 0 0
External Cause of Morbidity (V, W, X, Y) 123 0 0
Factors Influencing Health Status and Contact with Health Services (Z) 30 6 0
Codes for Special Purposes (U) 0 0 0
Grand Total 395 25 13
 Takeaways
▪ Of the 395 new ICD-10-CM codes, 123 of them are external cause codes to capture accidents and
injuries
▪ CMS also proposes 36 new codes for osteoporosis with current pathological pelvic fracture
▪ Other notable proposed code additions include:
• Several new codes for Sickle cell anemia
• Five new codes for Parkinson's disease with and without dyskinesia
• Four new codes for migraine with aura
• Three new codes for insulin resistance
 Takeaways
Other notable FY 2024 final ICD-10-CM code updates include:
▪ 24 new codes added to the disease of nervous system (G00 – G99) chapter
▪ 34 new codes added to the disease of eye and adnexa (H00- H59) chapter
▪ 36 new coded added to the disease of musculoskeletal system and connective
tissue (M00 – M99) chapter
▪ 22 new codes added and six revised in the congenital malformations,
deformations and chromosomal abnormalities (Q00-Q99) chapter
▪ 30 new codes added to and six invalidated from the factors influencing health
status and contact with health services (Z00 – Z99) chapter
Conventions - Etiology /Manifestation Convention
A. Conventions for the ICD-10-CM –
13. Etiology/manifestation convention (“code first”, “use additional
code” and “in diseases classified elsewhere” notes)
 General Guidelines - SDOH
B. General Coding Guidelines –
14. Documentation by Clinicians Other than the Patients Provider
▪ Code assignment is based on the documentation by the patients
provider
▪ There are few exceptions when code assignment may be based on
medical record documentation from clinicians who are not the patients
provider
▪ These exceptions include codes for:
• Social determinants of health (SDOH) classified to Chapter 21
 Chapter 1 - Certain Infectious and Parasitic Diseases
5) Sepsis due to a postprocedural infection
 Chapter 1 - Certain Infectious and Parasitic Diseases
Expanded list of “code first” codes for A40 (Streptococcal Sepsis) and A41 (other
sepsis). For example, both codes now instruct to code first for sepsis due to central
venous catheter (T80.211-)

New codes often create a ripple effect of changes throughout the code book
In relation to A41.54, there are many revisions to the index and tabular list
We can find more new codes in this chapter.
 Chapter 1 - Certain Infectious and Parasitic Diseases
(f) Screening for Covid-19
The following is added to the guidelines, for screening for covid 19
including pre-operative testing assign code Z11.52 encounter for
screening for covid 19, this code was added January 1 2021 and
replaced Z11.59 encounter for screening for other viral diseases for
covid 19 screening encounters on or after October 1 2023 assigned
code Z11.52
 Chapter 2 - Neoplasms
Familial adenomatous polyposis (FAP):

In the Table of Neoplasms, D13.9 is revised to D13.99 for a handful

of applicable body areas. There is also a collection of new Z codes
to report family history of FAP.
 Chapter 2 - Neoplasms
Desmoid Tumor:
 Chapter 3 – Diseases of the blood and blood-forming
Sickle Cell Disorders:
▪ We will find several additions and revisions in this chapter for reporting sickle-cell disorders
▪ There are also new codes for reporting Schwachman-Diamond syndrome (D61.02) and IgG4-
related disease (D89.84), and many parenthetical revisions
 Chapter 3 – Diseases of the blood and blood-forming
IgG4-Related disease:
Immunoglobulin G4-related disease (IgG4-RD) is also known as IgG4-related
systemic disease, hyper-IgG4 disease, IgG4-related autoimmune disease, IgG4-
associated disease, IgG4-related sclerosing disease, and IgG4-syndrome

IgG4-related disease (D89.84), and many parenthetical revisions

 Chapter 4 - Endocrine Disorders
Autosomal Dominant hypocalcemia (ADH):
A new subcategory houses several new codes to identify individuals
with ADH.
 Chapter 4 - Endocrine Disorders
Lysosome associated membrane protein 2 (LAMP2) deficiency
 Chapter 4 - Endocrine Disorders
Metabolic Disorders:
 Chapter 4 - Endocrine Disorders
Wasting disease (syndrome) :
 Chapter 6 - Diseases of Nervous System
Chronic Migraine:
Chronic migraine is a condition where you have frequent or long-lasting
episodes of headaches and migraines
 Chapter 6 - Diseases of Nervous System
Chronic Migraine and its Subcategory:
 Chapter 7 - Diseases of Eye and Adnexa
Strabismus:
▪ Several new subcategories and codes for reporting extraocular muscle entrapment are being
added under H50 Other strabismus
▪ The new codes (H50.62 – H50.68) identify which part of the extraocular muscle is affected and
laterality
.
 Chapter 7 - Diseases of Eye and Adnexa
Sickle Cell Retinopathy:
Other tabular modifications in this chapter include a new subcategory and new
codes under category H36 Retinal disorders in disease classified elsewhere for
reporting proliferative and non-proliferative sickle-cell retinopathy of eye and
adnexa
 Chapter 7 - Diseases of Eye and Adnexa
There are also new codes under H54 Blindness and low vision and
H57 Other disorders of eye and adnexa
 Chapter 7 - Diseases of Eye and Adnexa
H57 Other disorders of eye and adnexa
Chapter 9 - Diseases of the Circulatory System
Hypertension, Resistant:
▪ Assign code I1A.0, Resistant hypertension, as an additional code when apparent treatment
resistant hypertension, treatment resistant hypertension, or true resistant hypertension is
documented by the provider
▪ A code for the specific type of existing hypertension is sequenced first, if known
Chapter 9 - Diseases of the Circulatory System
Angina:
▪ Angina is a common ailment that is often dismissed, but patients with angina often experience
coronary microvascular dysfunction
▪ This condition is associated with significantly higher rates of major adverse cardiac events
Chapter 9 - Diseases of the Circulatory System
Myocardial Infarction with Coronary Microvascular Dysfunction:
Coronary microvascular dysfunction (CMD) is a condition that impacts the microvasculature by
restricting microvascular flow and increasing microvascular resistance
Chapter 9 - Diseases of the Circulatory System
Inappropriate Sinus Tachycardia (IST):
Inappropriate Sinus Tachycardia (IST) is a clinical syndrome characterized by a
sinus heart rate inexplicably higher than one hundred beats per minute at rest that
is associated with symptoms like palpitations, dyspnea or dizziness in the absence
of primary causes of tachycardia
Chapter 10 - Diseases of the Respiratory System
Obliterative Bronchiolitis Codes:
Chapter 10 - Diseases of the Respiratory System
Bacterial Pneumonia:
If the bacteria goes into your lungs, the air sacs in your lungs get infected and
inflamed. They fill up with fluid, and that causes pneumonia
Chapter 11 - Diseases of the Digestive System
New Codes added for Appendicitis:
Chapter 11 - Diseases of the Digestive System
Retroperitoneal Fibrosis:
Retroperitoneal fibrosis is a disorder in which inflammation and extensive scar
tissue (fibrosis) occur in the back of the abdominal cavity, behind (retro-) the
membrane that surrounds the organs of the digestive system (the peritoneum) this
area is known as retroperitoneal space
Chapter 11 - Diseases of the Digestive System
Retroperitoneal Hematoma:
Retroperitoneal hematoma is defined as bleeding into the
retroperitoneal space
Chapter 11 - Diseases of the Digestive System
Short Bowel Syndrome:
Short bowel syndrome is a condition in which your body is unable to
absorb enough nutrients from the foods you eat because you don’t
have enough small intestine
Chapter 11 - Diseases of the Digestive System
Short Bowel Syndrome:
Chapter 11 - Diseases of the Digestive System
Intestinal Failure:
Intestinal failure (IF) is the inability of the gut to absorb necessary
water, macronutrients (carbohydrate, protein, and fat), micronutrients,
and electrolytes sufficient to sustain life and requiring intravenous
supplementation or replacement.
Chapter 13 - Diseases of the Musculoskeletal System
Osteoporosis:
▪ Osteoporosis is a bone disease that develops when bone mineral density and bone mass
decreases, or when the quality or structure of bone changes
▪ This can lead to a decrease in bone strength that can increase the risk of broken bones
(fractures).
 Chapter 13 - Diseases of the Musculoskeletal System
New Codes for Osteoporosis:
42 new codes to help further define osteoporosis with pathological
fracture
Chapter 14 - Diseases of the Genitourinary System
Immunoglobulin A Nephropathy (Ig AN) :
▪ IgA nephropathy also known as Berger disease, is a kidney disease
▪ It happens when a germ-fighting protein called immunoglobulin A (IgA) builds up in the kidneys
▪ This causes a type of swelling called inflammation that, over time, can make it harder for the
kidneys to filter waste from the blood.
Chapter 14 - Diseases of the Genitourinary System
Immunoglobulin A Nephropathy (Ig AN) :
Chapter 14 - Diseases of the Genitourinary System
Membranous Nephropathy (MN) :
▪ Membranous nephropathy (MN), also known as membranous glomerulopathy, is one of the many
glomerular diseases causing nephrotic syndrome
▪ It is characterized by massive proteinuria (>3.5 g/day) and clinically presents with peripheral
edema, hypertension, frothy urine, and manifestations of thromboembolic phenomena
Chapter 14 - Diseases of the Genitourinary System
Nephrotic Syndrome:
Nephrotic is a group of symptoms that indicate the kidneys are not working properly
These symptoms include
▪ Too much protein in the urine, called proteinuria
▪ Low levels of a protein called albumin in blood called hypoalbuminemia
▪ Swelling in parts of the body, called edema
Chapter 14 - Diseases of the Genitourinary System
Nephrotic Syndrome Codes:
Chapter 14 - Diseases of the Genitourinary System
Isolated Proteinuria:
Isolated proteinuria is proteinuria without any abnormalities in urinary
sediment, hematuria, or a reduction in GFR and in the absence of
hypertension and diabetes
Chapter 14 - Diseases of the Genitourinary System
Isolated Proteinuria Codes:
 Chapter 15 - Pregnancy
Hepatorenal Syndrome (HRS) :
▪ Hepatorenal syndrome (HRS) is a multiorgan condition affecting the kidneys and
the liver
▪ It is a cause of acute kidney injury that can be seen in those with acute or chronic
liver disease
 Chapter 15 - Pregnancy
Hepatorenal Syndrome (HRS) Codes:
 Chapter 15 - Pregnancy
Intrahepatic Cholestasis of Pregnancy (ICP):
 Chapter 17 - Congenital Malformations
Alagille syndrome:
New Q codes and inclusion terms have been created to allow for
clearer identification of Alagille syndrome
 Chapter 17 - Congenital Malformations
Craniosynostosis:
Several codes are added under Q75 Other congenital malformations of
skull and face bones
 Chapter 17 - Congenital Malformations
Bardet-Biedl Syndrome (BBS):
BBS is a rare, autosomal recessive genetic disorder that can lead to
dysfunction of multiple organ systems, including the kidneys, genitalia,
brain, and ey.
 Chapter 17 - Congenital Malformations
Three codes are added under Q87.8 Other specified congenital
malformations syndromes
 Chapter 18 - Symptoms, Signs and Abnormal
Clinical and Lab Findings
Dense Breast Tissue:
There are several codes to identify the different types of breast density
 Chapter 18 - Symptoms, Signs and Abnormal
Clinical and Lab Findings
New codes for reporting foreign body sensation in various areas of the
circulatory and respiratory systems (R09.A-).
 Chapter 18 - Symptoms, Signs and Abnormal
Clinical and Lab Findings
A new code for the diagnosis of a nontraumatic coma due to an
underlying condition (R40.2A)
Chapter 19 - Injury, Poisoning, and Other External Causes
New Codes added for Toxic Effect of Gadolinium:
Chapter 20 - External Causes
123 codes updates in Chapter 20 to capture details around accidents
and injuries
Chapter 21 - Factors Influencing Health Status
SDoH Codes:
Several social determinants of health (SdoH) codes were added
including 8 of the 30 new codes in Chapter 21 - Factors Influencing
Health Status and Contact with Health Services (Z00-Z99), which
capture details related to child upbringing
Chapter 21 - Factors Influencing Health Status
Also in this chapter, a new code is added for acute HIV infection
syndrome and HIV pre-exposure prophylaxis (PrEP) to increase
awareness of PrEP among some at-risk groups, to enable wider use,
and reduce the burden of HIV disease, according to the requester.
 References
• https://www.cmc.gov/medicare/icd-10/2024 ICD-10-CM | CMS

• https://www.codingclinicadvisor.com/coding-handbook

• https://www.wolterskluwer.com/en/expert-insights/2024-icd10-code-updates

• https://www.norwood.com/codes-codes-and-more-codes-new-fy-2024-icd-10-cm-icd-10-pcs-codes-
hit-the-encoder/

• https://www.outsourcestrategies.com/blog/2024-icd-10-codes-guidelines/

• https://www.aapc.com/blog/88401-get-a-jump-on-diagnosis-code-changes-for-fy-2024/
Happy learning!
Thank you