The World Health Organization (WHO) and the Centers for Medicare and Medicaid Services (CMS) have released the updates for the International Classification of Diseases, Tenth Revision (ICD-10) for the fiscal year 2023.
Staying informed about crucial updates is crucial for chiropractic providers. Practices should know that only a few of these changes are relevant to chiropractors. The changes in ICD-10 chiropractic codes and guidelines will be effective from October 1, 2023 and will remain active till September 2024. We will look into the changes in ICD-10-CM for 2024, this blog offers insights into the significant changes that are set to influence the field of chiropractic coding and billing.
The new changes and updates to ICD-10 codes for chiropractors should help providers and billers provide accurate documentation and reporting of chiropractic diagnosis codes and procedures.
Why Chiropractic Practices Should Know About 2023-24 ICD-10 Updates
Chiropractic providers must “code to the highest level of specificity.” Insurance companies base their reimbursement on the chiropractic ICD-10 codes you list on the HCFA claim form. Using an unspecified code when a more specific code is accurate might result in denied claims and delayed payments. Unspecified codes yield limited information. The aim of providers should always be to get to the most granular level of classification detail. Knowing the latest changes to ICD-10 codes for chiropractors will ensure your billers and codes are assigning the most appropriate codes when submitting claims.
The Fiscal Year 2023-24 ICD-10 Diagnosis Code Updates
Many changes to the ICD 10 codes for chiropractic specify site and laterality, indicating the affected bone, joint, or muscle. Conditions like osteoarthritis may involve multiple sites, covered by a “multiple sites” code. In cases without such a code, use multiple codes to denote each affected site.
#1. Site and Laterality: Bone vs Joint
In some cases, conditions like avascular necrosis of bone (M87) or osteoporosis (M80, M81) may affect the upper or lower end of the bone. Despite the bone’s involvement near a joint, the site designation remains the bone, not the joint.
#2. 7th Character A
#3. Osteoporosis ICD-10 Codes
#4. Multisystem inflammatory syndrome (MIS)
For patients diagnosed with multisystem inflammatory syndrome (MIS) alongside COVID-19, list U07.1, COVID-19, as the primary diagnosis and M35.81, Multisystem inflammatory syndrome, as a secondary diagnosis.
If a patient with a COVID-19 history develops MIS, use M35.81 and U09.9, Post COVID-19 condition, unspecified. For those with known or suspected exposure to COVID-19 but no current infection or history of it, assign M35.81 and Z20.822, Contact with and (suspected) exposure to COVID-19.
Additional codes are needed for associated conditions.As the code for back pain M54.5 has been deleted, providers can use it to specify a condition if it does not fit the category of vertebrogenic low back pain and unspecified low back pain.
#5. Post COVID-19 Condition
For sequela of COVID-19, or associated symptoms or conditions that develop following a previous COVID-19 infection, assign a code(s) for the specific symptom(s) or condition(s) related to the previous COVID-19 infection, if known, and code U09.9, Post COVID-19 condition, unspecified.
Code U09.9 should not be assigned for manifestations of an active (current) COVID-19 infection.
Conclusion
This blog does not cover all of the changes to the ICD 10 chiropractic codes, but rather gives you a glimpse of the changes specific to chiropractic practices. It is important that your billers, coders, and providers know about the common chiropractic ICD-10 codes and read over the complete changes and updates. To see the complete list of changes, click here.
If you’re a zHealth customer, don’t worry! We’ve added the new ICD-10 chiropractic codes to zHealth Software. However, you will need to add them to your “included” ICD-10 codes if you want them to be visible in your SOAP notes or invoices. If you need more help with the common chiropractic ICD-10 codes and the recent changes, contact our expert billers and coders at [email protected]. To learn more about zHealth Software, request a free demo here.
Also read:
ICD-10 Chiropractic Codes: The Application of A, D and S Extensions
ABCDE Of Chiropractic Codes – How To Get Paid What You Deserve
Know The Top Chiropractic CPT Codes That Can Save Your Billing Time
