Prepare for 2024 E/M changes and FY 2023 ICD-10-CM codes

Medical code changes happen every year, and it can be overwhelming to keep track of what codes are new, revised, and deleted. This article highlights several important changes to evaluation and management (E/M) codes that take effect January 1, 2024, as well as several ICD-10-CM diagnosis code changes that became effective October 1, 2023. Our goal is to help you ensure clean claims, reduce denials, and promote revenue integrity in your medical practice.

In the 2024 CPT code update, you’ll find notable E/M-related changes for:

In total, the annual update to the CPT code set created 349 editorial changes, including 230 additions, 49 deletions, and 70 revisions. This includes the consolidation of more than 50 previous codes that streamline the reporting of immunizations for COVID-19.

The CPT Editorial Panel also approved the provisional codes (91318-91322) to identify monovalent vaccine products from Moderna and Pfizer for immunization against COVID-19.

Want to learn more about the changes? Take a look at this AMA press release and monitor the CMS website for an updated code list. You can also read this AMA article and definitely be sure to purchase a 2024 CPT Manual. 

The fiscal year (FY) 2024 ICD-10-CM code updates that took effect October 1, 20223 includes 395 code additions, 25 code deletions, and 13 code revisions. Here are some of the most notable changes:

A new ICD-10-CM diagnosis code for resistant hypertension (I1A.0) captures cases where a patient’s hypertension does not respond well to aggressive medical treatment. 

Four new codes for metabolic disorders replace ICD-10-CM diagnosis code E88.81 (metabolic syndrome): 

New ICD-10-CM diagnosis code for chronic migraine with aura (G43.E) provides additional specificity in terms of ‘intractable vs. not intractable’ and ‘with or without status migrainosus.’ 

Four new, more specific ICD-10-CM diagnosis codes for Parkinson’s disease replace ICD-10-CM code G20 (Parkinson’s disease):

There’s also a new ICD-10-CM diagnosis code for unspecified Parkinsonism (G20.C). This is a general healthcare term for a group of neurological disorders causing movement problems similar to those seen in Parkinson’s disease (e.g., tremors, slow movement, and stiffness).

CPT no longer includes ICD-10-CM diagnosis code J15.6 (pneumonia due to other gram-negative bacteria). Instead, report 1 of these 2 new, more specific medical codes:

There’s a new ICD-10-CM diagnosis code for dense breasts, unspecified (R92.3). 

Be sure to put these two new ICD-10-CM diagnosis codes on your radar:

Similarly, make sure you’re aware of these five new ICD-10-CM diagnosis codes for conflicts children may have with relatives or guardians:

Finally, note that there are 2 new ICD-10-CM diagnosis codes for noncompliance due to financial hardship:

Consider these 3 strategies to ensure a compliant healthcare revenue cycle and promote revenue integrity in your medical practice:

Ensure coders understand the new codes and review the FY 2024 ICD-10-CM official guidelines for coding and reporting that provide additional reporting instructions. In this article, we’ve only provided a snapshot of the changes. There are plenty of other new codes that may also affect your medical practice and specialty. 

Educate physicians and other providers who document in the medical record to ensure their documentation supports the additional specificity inherent in many of the new codes. 

The new ICD-10-CM diagnosis codes have been in effect for almost a month, and now is a great time to audit claims. Plan to do the same again in January or February after the new CPT codes take effect.

The 4th quarter is always a busy time of year for medical practices, and understanding new medical codes can pose a challenge. However, with a bit of proactive planning and education, coders, physicians, and others will be able to report new codes with confidence and avoid denials.