ED Coding and Reimbursement Alert

Remember, these codes take effect before 2023.

The numbers are in, and they’re staggering. The World Health Organization (WHO) has released its list of ICD-10 additions, deletions, and revisions for 2023. And there are a lot of them.

In a nutshell: ICD-10 2023 will feature:

• 1,468 new codes,
• 251 deleted codes,
• 35 revised codes, and
• 36 codes converted to parent.

In this (and upcoming) issues, we’ll take a look at the new ICD-10 codes ED coders are going to want to know before ICD-10 takes effect. And remember, that effective date is Oct. 1, 2022, so the clock is already ticking.

Use This Guide to Get to the New Concussion/TBI Codes

Since there are so many ICD-10 codes to address, we’re going to focus first on concussion and other traumatic brain injury (TBI) code sets that are being added next year. Here’s how we’ll address these codes:

• Code set identified.
• Map to new code.
• Map to any additional code(s) based on first new code.
• Analysis of the addition.

Code set S06.0X- (Concussion)

This established code leads to new code S06.0XA- (Concussion with loss of consciousness status unknown).

Once you get to S06.0XA-, you’ll have this code for use in ICD-10 2023:

• S06.0XAA (Concussion with loss of consciousness status unknown, initial encounter)

Impact: Adds loss of consciousness status unknown but confirmed concussion to code set.

Code set S06.1X- (Traumatic cerebral edema)

This established code leads to new code S06.1XA- (Traumatic cerebral edema with loss of consciousness status unknown). Once you get to S06.1XA-, you’ll have this code for use in ICD-10 2023:

• S06.1XAA (Traumatic cerebral edema with loss of consciousness status unknown, initial encounter)

Impact: Adds loss of consciousness status unknown but confirmed traumatic cerebral edema to code set.

“Reporting clinically significant traumatic cerebral edema is important when trying to support the complexity level of a diagnostic-related group using a secondary diagnosis,” explains Gregory Przybylski, MD, immediate past chairman of neuroscience and director of neurosurgery at the New Jersey Neuroscience Institute, JFK Medical Center in Edison, New Jersey. “This and similar diagnoses should additionally be reported along with the applicable primary diagnosis when clinically significant cerebral edema significantly impacts the patient’s care, as exemplified by additional testing, treatment, and/or length of stay extension as a direct consequence of the secondary diagnosis of cerebral edema.”

The medical record should reflect this clinical significance to warrant reporting the secondary diagnosis of cerebral edema.

Code set: S06.2X- (Diffuse traumatic brain injury)

This established code leads to new code S06.2XA- (Diffuse traumatic brain injury with loss of consciousness status unknown). Once you get to S06.2XA-, you’ll have this code for use in ICD-10 2023:

• S06.2XAA (Diffuse traumatic brain injury with loss of consciousness status unknown, initial encounter)

Impact: Adds loss of consciousness status unknown but confirmed diffuse TBI.

Code set: S06.30- (Unspecified focal traumatic brain injury)

This established code leads you to new code S06.30A- (Unspecified focal traumatic brain injury with loss of consciousness status unknown). Once you get to S06.30A-, you’ll have this code for use in ICD-10 2023:

• S06.30AA (Unspecified focal traumatic brain injury with loss of consciousness status unknown, initial encounter)

Impact: Adds loss of consciousness status unknown but confirmed unspecified focal TBI.