Fiscal Year 2023 in Full Swing for Revenue Cycle Coders

1,491 diagnosis code changes were finalized earlier this year and became effective October 1.

Revenue cycle leaders should make sure that middle revenue cycle staff are up to date and using the most recent diagnosis and procedure codes as fiscal year 2023 is now in full swing and it is sure to affect hospital reimbursement.

The 2023 ICD-10-CM update includes almost 1,500 changes. Here are a few examples of the updates that your coding and CDI teams should be expected to know:

Sixty-nine new codes were created to identify the severity of dementia (i.e., mild, moderate, or severe) with or without certain behavioral symptoms including:

• Agitation, which includes aberrant motor behavior such as restlessness, rocking, pacing, or exit-seeking; and verbal or physical behaviors such as profanity, shouting, threatening, anger, aggression, combativeness, or violence
• Anxiety
• Mood disturbance including depression, apathy, or anhedonia
• Psychotic disturbance including hallucinations, paranoia, or suspiciousness or delusional state
• Other behavioral disturbances such as sleep disturbance and social or sexual disinhibition

There are 43 new codes in the “diseases of the circulatory system” section—many of which add specificity to existing codes. For example, in order of ICD-10-CM chronology, the new codes relate to the following diagnoses:

• Refractory angina pectoris
• Atherosclerosis from bypass graft
• Pericardial effusion
• Nonrheumatic mitral valve disorders
• Ventricular tachycardia
• Dissection of aorta
• Aortic aneurysm (ruptured and without rupture)
• Antineutrophilic cytoplasmic antibody vasculitis

As for the inpatient procedure codes, CMS announced a modest amount of changes to the ICD-10-PCS code set, including 331 new procedure codes and 64 codes deletions. The agency did not make any code revisions.

For example, approximately 67% of new ICD-10-PCS codes for 2023 are for laser interstitial thermal therapy (LITT), which is an emerging, minimally invasive surgical technique that uses a small laser to destroy unhealthy tissue from the inside out.

ICD-10-PCS codes for LITT were deleted from the Radiation Therapy section and added to the Medical and Surgical section. These codes were moved because LITT involves tissue destruction performed using a laser probe with thermal energy rather than ionizing radiation, according to Kimberly Cunningham, CCS, CPC, instructor for Certified Coder Boot Camps at HCPro in Middleton, Massachusetts.

The coding department is one of the most critical parts of the revenue cycle. Because coding occurs mid-cycle, it provides an opportunity to catch errors introduced earlier in the process, as well as preventing similar errors in the future.

Staying abreast of these regulatory coding updates is important for revenue cycle leaders as coding—and its completeness and accuracy—has a profound impact on an organization's bottom line.