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Improve your medical practice’s financial sustainability: Leverage the 2024 ICD-10-CM, ICD-10-PCS, CPT, and HCPCS coding updates

Understand the updated 20214 ICD-10 medical billing codes to promote clean claims and increase revenue.

Person reviewing patient response information.

Every year, hundreds of new medical codes enable healthcare providers to capture the totality of each patient’s unique story. These medical codes along with other important details on the medical claim unlock the ‘who,’ ‘what,’ ‘where,’ ‘when,’ and ‘why’ of each healthcare encounter. 

It’s important to understand the changes and report accurate codes to promote clean claims, enhance data analytics and population health management, and improve revenue integrity.

The good news? 

In fiscal year (FY) 2024, the details of that story will be richer and more specific than ever. Every year, medical codes become more specific as we learn new information about health outcomes and patterns and develop new healthcare technologies and procedures. The pace of change will likely continue to increase over time, making comprehensive revenue cycle management a necessary business strategy. 

What’s included in the medical coding updates for FY 2024?

There are three types of medical codes to put on your radar—CPT, ICD-10 (CM and PCS), and HCPCS Level II codes. But, what is the relationship between CPT, ICD-10, and HCPCS Level II codes? 

Each type conveys different information to payers, providers, regulators, researchers, and others. However, they’re all equally important in the big picture, and they’re all necessary to tell a complete and accurate story. Consider the following:

  • CPT codes describe the outpatient procedures or services patients receive. 
  • ICD-10-CM codes reflect why patients receive those services or procedures, including any severity of illness or risk of mortality. These are the diagnosis codes that describe current conditions and, in some cases, previous conditions as well.
  • ICD-10-PCS codes describe inpatient procedures or services patients receive.
  • HCPCS Level II codes identify supplies, drugs, and certain professional services.

Following are some common questions about medical coding updates for 2024. As you review these questions, be sure to also take a look at the list of telehealth services for calendar year (CY) 2024. These are services payable under the Medicare Physician Fee Schedule when furnished via telehealth through December 31, 2024. 

Now is a great time to re-evaluate your telehealth strategy and give it a boost, if needed.

What ICD-10-CM diagnosis codes are changing for FY 2024?

There are 395 new ICD-10-CM diagnosis codes that took effect October 1, 2023. For example, there are more specific medical codes for pneumonia, Parkinson’s disease, chronic migraines, metabolic disorders and insulin resistance, and more. 

New codes to cover previously unreported information

There are also new medical codes to help providers capture information that would have previously been unreported, such as resistant hypertension, dense breasts, certain child custody arrangements, familial conflict, and caregiver non-compliance. Again, it’s about telling the patient’s entire story as accurately as possible.

The new ICD-10-CM codes are broken down by chapter in the FY 2024 ICD-10-CM coding manual. ”

Here's how the new ICD-10-CM codes are broken down by chapter in the FY 2024 ICD-10-CM coding manual:

  • 2 new codes in Chapter 1 (Certain infectious and parasitic diseases, A00-B99)
  • 21 new codes in Chapter 2 (Neoplasms, C00-D49)
  • 8 new codes in Chapter 3 (Diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism, D50-D89)
  • 18 new codes in Chapter 4 (Diseases of the endocrine system, E00-E89)
  • 24 new codes in Chapter 6 (Diseases of the nervous system, G00-G99)
  • 34 new codes in Chapter 7 (Diseases of the eye and adnexa, H00-H59)
  • 10 new codes in Chapter 9 (Diseases of the circulatory system, I00-I99)
  • 7 new codes in Chapter 10 (Diseases of the respiratory system, J00-J99)
  • 18 new codes in Chapter 11 (Diseases of the digestive system, K00-K95)
  • 43 new codes in Chapter 13 (Diseases of the musculoskeletal system and connective tissue, M00-M99)
  • 15 new codes in Chapter 14 (Diseases of genitourinary system, N00-N99)
  • 6 new codes in Chapter 15 (Pregnancy, childbirth, and puerperium, O00-O9A)
  • 22 new codes in Chapter 17 (Congenital malformations, deformations, and chromosomal abnormalities, Q00-Q99)
  • 10 new codes in Chapter 18 (Signs and symptoms, R00-R99)
  • 4 new codes in Chapter 19 (Injuries, poisonings, and certain other consequences of external causes, S00-T88)
  • 123 new codes in Chapter 20 (External causes of morbidity, V00-Y99)
  • 30 new codes in Chapter 21 (Factors influencing health status and contact with health services, Z00-Z99)

If you want to know how to apply these codes, be sure to check out the FY 2024 ICD-10-CM official coding guidelines — particularly the text in bold font that indicates new information.

To learn more about all of the ICD-10-CM code changes for 2024, including the 25 code deletions and 13 code revisions, visit  https://www.cms.gov/medicare/coding-billing/icd-10-codes/2024-icd-10-cm

How many of the new ICD-10-PCS codes for FY 2024 are found in the new technology section?

There are 78 new ICD-10-PCS procedure codes that took effect October 1, 2023. The ICD-10 MS-DRG Grouper software package that accommodates the new codes (Version 41.1) takes effect for discharges on or after April 1, 2024.

More than 40 of the new ICD-10-PCS codes for 2024 denote new technologies (i.e., new procedures, substances, and devices) assigned to one of the following ICD-10-PCS tables:

  • X05 (New Technology Section, Nervous System, Destruction)
  • X2H (New Technology Section, Cardiovascular System, Insertion)
  • X2U (New Technology Section, Cardiovascular System, Supplement)
  • X2K (New Technology Section, Cardiovascular System, Bypass)
  • XNH (New Technology Section, Bones, Insertion)
  • XNR (New Technology Section, Bones, Replacement)
  • XRG (New Technology Section, Joints, Fusion)
  • XW0 (New Technology Section, Anatomical Regions, Introduction)
  • XW1 (New Technology Section, Anatomical Regions, Transfusion)
  • XX2 (New Technology Section, Physiological Systems, Monitoring)
  • XXE (New Technology Section, Physiological Systems, Measurement)

For example, 

  • ICD-10-PCS code X051329 denotes the Paradise™ Ultrasound Renal Denervation System designed to decrease the over-activity of the nerves leading to the kidney. 
  • ICD-10-PCS code table ‘X2H’ includes codes for a new technology called the Impella® 5.5 with SmartAssist® System, a temporary ventricular support device intended for short-term use. The device is indicated for the treatment of ongoing cardiogenic shock that occurs immediately (< 48 hours) following acute myocardial infarction or following open-heart surgery. 
  • ICD-10-PCS code table ‘XNH’ includes codes for a new technology called the Canturio™ tibial extension that is implanted to increase the stability of the tibial plate. 

There are many new technologies to review and put on your radar for 2024. Also, be sure to review the 2024 ICD-10-PCS official guidelines for coding and reporting. To learn more about the changes, visit https://www.cms.gov/medicare/coding-billing/icd-10-codes/2024-icd-10-pcs

What are the most important CPT changes for FY 2024?

There are 230 new CPT codes that take effect January 1, 2024, including five new CPT codes for product-specific RSV immunizations (i.e., 90380, 90381, 90683, 90679, and 90678), notable changes to office visit evaluation and management (E/M) codes, and new codes for caregiver training services (96202, 96203, 97550, 97551, and 97552).

In addition, effective November 1, 2023, a new vaccine-administration code (90480) for the administration of any COVID-19 vaccine for any patient, replaced all previously approved specific vaccine administration codes

There are 345 HCPCS Level II codes that took effect January 1, 2024. ”

To learn more about all of the CPT changes for 2024, visit https://www.ama-assn.org/press-center/press-releases/ama-releases-cpt-2024-code-set

What are the most important HCPCS Level II changes for FY 2024? 

There are 345 HCPCS Level II codes that took effect January 1, 2024. These include:

  • 75 new ‘A’ codes for transportation services, medical and surgical supplies, and administrative services
  • 20 new ‘C’ codes for outpatient services
  • 15 new ‘E’ codes for durable medical equipment
  • 16 new ‘G’ codes for professional services reported to Medicare 
  • 33 new ‘J’ codes for non-oral administered drugs
  • 3 new ‘L’ codes for orthotic procedures and services
  • 160 new ‘M’ codes for medical services
  • 23 new ‘Q’ codes for temporarily reporting a range of services and supplies

New potential revenue-building codes

Be sure to review these new HCPCS codes to determine whether you may be able to generate additional revenue:

  • G0019 for the first 60 minutes of community health integration per calendar month. 
  • G0022 for each additional 30 minutes of community health integration per calendar month. 
  • G0136 for social determinants of health risk assessments. Note that for CY 2024, Medicare added this code on a permanent basis to the list of covered telehealth services. 
  • G2211 for E/M add-on services. Note: Here are some helpful examples of when and how to report G2211.
  • G0023 for the first 60 minutes of principal illness navigation services patient navigators perform per calendar month.
  • G0024 for each additional 30 minutes of principal illness navigation services patient navigators perform per calendar month.  
  • G0140 for the first 60 minutes of principal illness navigation services certified peer specialists perform per calendar month. 
  • G0146 for each additional 30 minutes of principal illness navigation services certified peer specialists perform per calendar month.  

Here’s a good summary of the CY 2024 Medicare Physician Fee Schedule Final Rule that explains how to bill these and many other new codes. Be sure to review this concise document with your medical coding and billing teams as well as physicians and other providers in the medical practice.

To learn more about HCPCS Level II coding updates, visit HCPCS Quarterly Update | CMS

What’s the best way to prepare for ICD-10 medical coding changes for 2024?

The bottom-line answer to that question is education, education, education. 

Educate yourself on what’s new and how it might impact clinical documentation and other workflows. With the 2024 medical coding update, there are countless opportunities to capture greater specificity, address healthcare disparities, improve outcomes, and boost medical practice revenue. Understanding the changes is paramount. 

Work together with your staff to identify changes that impact your medical practice and strive for data and revenue integrity in 2024 and beyond.

Lisa Eramo, freelance healthcare writer

Lisa A. Eramo, BA, MA is a freelance writer specializing in health information management, medical coding, and regulatory topics. She began her healthcare career as a referral specialist for a well-known cancer center. Lisa went on to work for several years at a healthcare publishing company. She regularly contributes to healthcare publications, websites, and blogs, including the AHIMA Journal. Her focus areas are medical coding, and ICD-10 in particular, clinical documentation improvement, and healthcare quality/efficiency.

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