Five Major ICD-10-CM Changes That Can Effect Your Organization

by  Aimee L. Wilcox, CPMA, CCS-P, CST, MA, MT
Oct 14th, 2021

On October 1, 2021, the ICD-10-CM code changes became effective. This means that claims to certain health insurance payers must be updated to reflect the changes as of this date. If your practice is one that handles workers compensation claims, it will be important to determine  which year of the ICD-10-CM, HCPCS, and CPT codes your state will be using  and comply with those requirements, while simultaneously fulfilling obligations for Medicare, Medicaid, and other commercial payers who use the most up-to-date codesets. On October 7th, Find-A-Code presented a webinar, “2021 ICD-10-CM Guideline and Code Changes” (free to the public) pointing out the many guideline and code changes, additions, and deletions. 

Five (5) Major ICD-10-CM Changes FY 2022 (Effective October 1, 2021)  

The following list contains five of the most significant changes to the ICD-10-CM code set which became effective on October 1, 2021:

1. Other clinician's documentation may be used to report laterality when the treating provider has not included it in the encounter note. Special criteria must be met.
2. Reporting an unspecified diagnosis is strongly discouraged and may elicit a request for medical records by payers. 
3. The addition of several new Social Determinants of Health (SDoH) codes and clarification of reporting SDoH documented by providers other than the provider of record.
4. The addition or expansion of widely reported conditions and symptoms such as: 
1. Depression, unspecified vs Major depression, single episode
2. Cough to include acute, subacute, and chronic along with other descriptive types of coughs
3. Low back pain vs vertebrogenic low back pain
5. Many official guidelines were added throughout 2020 and 2021 that are now present in the updates, especially additional changes to the COVID-19 coding guidelines.

Free ICD-10-CM FY 2022 (Effective October 1, 2021) Changes Webinar 

innoviHealth is lending a helping hand to coders and healthcare professionals to help them stay on top of the many ongoing regulatory and compliance changes taking place by continuing to offer this webinar for free through October 20, 2021. Click HERE to register for immediate access to learn about these five and all of the other ICD-10-CM changes. 

About Aimee L. Wilcox, CPMA, CCS-P, CST, MA, MT

Aimee L. Wilcox is a medical coding, billing, and auditing consultant, author, and educator with more than 30 years of clinical and administrative experience in healthcare, coding, billing, and auditing. Medicine, including coding and billing, is a constantly changing field full of challenges and learning and she loves both. Aimee believes there are talented medical professionals who, with proper training and excellent information, can continue to practice the art of healing while feeling secure in their billing and reimbursement for such care.