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The new updates to the ICD-10-CM code system include 42 additions and one revision. The Centers for Disease Control and Prevention (CDC) along with National Center for Health Statistics (NCHS) is implementing these codes into the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) effective from April 1st, 2023.
The purpose of this update is to enable the collection of health-related social needs (HRSNs) in a better way. Additionally there is one update in the guidelines I.C.21.c.17. Social Determinants of Health.
Take a look at the below table for the overview of the update.
New codes in Chapter 19:
12 new codes are added in Chapter 19: Injury, Poisoning, and Certain Other Consequences of External Causes (S00-T88)
These new codes specify whether the financial abuse concerns an adult or child and also highlight whether it’s an initial or subsequent encounter or a sequela.
Child and adult financial abuse:
Financial abuse occurs when a perpetrator limits the access to financial assets in order to control the victim. Without financial resources, the victim of the abuse has limited options for separating from the perpetrator. This includes any of various methods used to withhold money, steal money or control assets that rightly belong to the victim.
Below are two new categories added for the Child and adult financial abuse for confirmed and suspected cases.
Confirmed: T74.A- Financial abuse, confirmed
T74.A1- Adult financial abuse, confirmed
T74.A2 Child financial abuse, confirmed
Suspected: T76.A- Financial abuse, suspected
T76.A1- Adult financial abuse, suspected
T76.A2- Child financial abuse, suspected
New codes in Chapter 20:
In the below table, you can find the 15 new codes and their description added to Chapter 20: External Causes of Morbidity (V00-Y99)
These new codes specify the perpetrator as one of the following: husband, wife, male partner, female partner (The new codes specify if the perpetrator is a current or former spouse or partner) non-binary partner child, grandchild, grandparent, parental sibling, or acquaintance or friend.
New codes in Chapter 21:
15 new codes are added in Chapter 21: Factors Influencing Health Status and Contact with Health Services (Z00-Z99).
Social determinants of health (SDOH) codes describe the social problems, conditions, or risk factors that influence a patient’s health.
Problems related to education and literacy Z55
Z55.6 Problems related to health literacy
Difficulty understanding health related information
Difficulty understanding medication instruction
Problem completing medical forms
Problems related to physical environment Z58
Z58.8 Other problems related to physical environment
Z58.81 Basic services unavailable in physical environment
Unable to obtain internet service, due to unavailability in geographic area
Unable to obtain telephone service, due to unavailability in geographic area
Unable to obtain utilities, due to inadequate physical environment
Z58.89 Other problems related to physical environment
Problems related to housing and economic circumstances Z59
Below are the new expansions from this category
Z59.1 Inadequate housing
Z59.10 Inadequate housing, unspecified
Inadequate housing NOS
Z59.11 Inadequate housing environmental temperature
Lack of air conditioning
Lack of heating
Z59.12 Inadequate housing utilities
Lack of electricity services
Lack of gas services
Lack of oil services
Lack of oil services
Excludes 2: Basic services unavailable in physical environment (Z58.81)
Lack of adequate food (Z59.4-)
Other problems related to housing and economic circumstances (Z59.8-)
Z59.19 Other inadequate housing
Pest infestation
Restriction of space
Technical defects in home preventing adequate care
Unsatisfactory surroundings
Code revision
Code description is revised for the code Z59.87 from “Material hardship” to “Material hardship due to limited financial resources, not elsewhere classified”
Z59.87 Material hardship due to limited financial resources, not elsewhere classified
Material deprivation due to limited financial resources
Unable to obtain adequate childcare due to limited financial resources
Unable to obtain adequate clothing due to limited financial resources
Unable to obtain adequate clothing due to limited financial resources
Unable to obtain basic needs due to limited financial resources
Problems related to upbringing Z62 new expansions
Z62.814 Personal history of child financial abuse
Excludes1: current child financial abuse (T74.A2)
Z62.815 Personal history of intimate partner abuse in childhood
Excludes2: adult and child abuse, neglect and other maltreatment, confirmed (T74.-)
Non compliance with medication regimen
New codes under subcategory Z91.14 to identify the patient's non compliance with medication regimen due to either financial hardship or another reason.
Similar additions under subcategory Z91.15 to identify the patient's non compliance with renal dialysis due to either financial hardship or another reason.
Two new codes added under subcategory Z91.4 Personal history of psychological trauma, not elsewhere classified to describe a personal history of adult adult financial abuse (Z91.413) and personal history of adult intimate partner abuse (Z91.414)
I.C.21.c.17. Social Determinants of Health
Below guideline change related to SDOH and clarifies that the SODH codes describe social problems, conditions and risk factors. These codes should be assigned when information is documented in the medical record.
Code Z06.2 Living alone is assigned when the patient has a risk or unmet need for assistance at home due to living alone, not that they merely live alone.
Patient reported information that is signed off by a clinician can be used to support code assignment.
Table of drugs and chemicals
There are 7 minor fixes for the code T43.65- as revised the 6th character from 2 (self-harm) to 3 (assault) for the all entries related to drug Metamfetamine for below entries in table of drugs and chemicals.
Desoxyephedrine, Metamfetamine, Methamphetamine, Methedrine, Methyl-amphetamine, Methylamphetamine and Speed.
References:
CMS: https://www.cms.gov/files/zip/icd-10-ms-drgs-v401-effective-april-1-2023.zip
