New ICD-10-CM Codes for Wound Management Fiscal Year 2022: Part 1

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To our readers: This year, something a bit different for you. My article on the 2022 ICD-10-CM updates will be split into 2 parts. The first part here is dedicated to the new ICD-10-CM codes. Part 2, to appear later this year, will be dedicated to changes to the coding guidelines that may affect wound care practices.

The new 2022 codes are here! In the 2022 version of ICD-10-CM, there are a total of 72,748 codes, including 159 additions, 32 deletions, and 20 revisions. While I have provided these codes for wound care, you may click here to check the new code file for your own reference at the National Center Health Statistics. 

Between now and October 1, 2021, is an excellent time to review the new ICD-10-CM codes associated with wound management. The new Fiscal Year 2022 ICD-10-CM codes, which become effective on October 1, 2021, are not numerous. I have put them into groups that include irritant contact dermatitis, anemia and blood disorders, thrombotic microangiopathy, and new Z codes.  

To view the entire list of new and revised ICD-10-CM codes, refer to Tables 6A-F in the Acute Inpatient Prospective Payment System (IPPS) Proposed 2022 Rule at this link:

The IPPS Final Rule was published on August 13, 2021.  

New 2022 ICD-10-CM Codes

New ICD-10-CM codes that may be pertinent to wound management are displayed in Table 1, which is divided into 4 sections of new codes: irritant contact dermatitis, anemia and blood disorders, thrombotic microangiopathy/other, and new Z codes.  

Revised 2022 ICD-10-CM Codes

Revised ICD-10-CM code descriptions for existing ICD-10-CM codes are included in Table 2. They include pneumonia due to coronavirus, morbid obesity codes, and a personal history of immunosuppressive therapy.

Changes to CC and MCC Systems 2022

There are significant additions and deletions to the Complication/Comorbid (CC) factor listing and the Major Complication/Comorbid (MCC) factors. As a reminder, these conditions indicate an increase in the severity of inpatient cases. Readers need to be aware of these changes as they may impact your Merit-based Incentive Payment System/ Medicare Access and CHIP Reauthorization Act (MIPS/MACRA) performance statistics. For example, you should check any of your most commonly used diagnosis codes in your clinic to see if they have been changed from a CC to an MCC, or whether they have been removed as a CC or MCC. The MCC and CC listings also specify codes that have been removed from each listing.

The tables listed below can be found at the website link to the Acute Inpatient final rule tables as listed in the first paragraph:
•    Table 6G.1    Secondary Diagnosis Order Additions to the CC Exclusions List
•    Table 6G.2    Principal Diagnosis Order Additions to the CC Exclusions List
•    Table 6H.1    Secondary Diagnosis Order Deletions to the CC Exclusions List
•    Table 6H.2    Principal Diagnosis Order Deletions to the CC Exclusions List
•    Table 6I.        Complete MCC List; Table 6I.1- Additions to the MCC List
•    Table 6I.2      Deletions to the MCC List
•    Table 6J.       Complete CC List
•    Table 6J.1     Additions to the CC List
•    Table 6J.2     Deletions to the CC List
•    Table 6K.      Complete List of CC Exclusions

Recommended Implementation Actions for New and Revised 2020 ICD-10-CM Codes

After reviewing the new and revised 2022 ICD-10-CM codes, wound management professionals should:

1.    Review the new 2022 ICD-10-CM code changes with your clinical and revenue cycle staff.

2.    Ensure that the new 2022 ICD-10-CM codes are added to your electronic billing systems and forms.

3.    Review all pertinent Medicare National Coverage Determinations (NCD) and Local Coverage Determinations (LCD) (e.g. wound management, cellular and/or tissue-based products for skin wounds, hyperbaric oxygen therapy, electrical stimulation and electromagnetic therapy) that are updated due to the ICD-10-CM code changes. The Centers for Medicare & Medicaid Services have already updated the NCDs, and most Medicare Administrative Contractors (MACs) have updated their LCDs to reflect the 2022 new/revised ICD-10-CM codes.

4.    Review the MCC and CC listings to see the most common codes for wound management. Select those common to your wound management practice and ensure that they are documented and coded correctly to ensure credit for these severity-related conditions as they occur with your patients.  

Here’s to a great 2022! Stay tuned for the changes to the Hospital Outpatient Prospective Payment Systems and to the Medicare Physician Fee Schedule, which will be released sometime this fall and will be implemented on January 1, 2021.

Click here for a PDF of this article and the tables.
 
Donna Cartwright is senior director of health policy and reimbursement at Integra LifeSciences Corp., Plainsboro, NJ. She is approved as an AHIMA-approved ICD-10-CM/PCS trainer, and she has been designated as a fellow of the American Health Information Management Association.