FY 2024 ICD-10-CM Updates: Begin with A Bumpy Start
The FY2024 ICD-10-CM codes have had a problematic release. The original release was on June 16, with a second release on June 29. Finally, an erratum was released on July 26, which provided corrections to the Index and Tabular volumes with no additional diagnosis codes.
This release of diagnosis codes has 395 new codes, 25 deletions, and 13 revisions. The FY24 ICD-10-CM classification totals 74,044 codes.
Major Changes by Chapter
Chapter 1 – Certain Infectious and Parasitic Diseases
There are two additions to this chapter: A41.54 (sepsis due to Acinetobacter baumannii); and B96.83 (Acinetobacter baumannii as the cause of diseases classified elsewhere). The Acinetobacter baumannii infections were presented at the ICD-10 Coordination and Maintenance Committee Meeting of September 2022. This is a gram-negative infection commonly found in the environment.
Chapter 2 – Neoplasms
There are 13 additions to this chapter, with two deletions. The deletions are because the diagnosis code has been expanded. D13.9 has been expanded to include familial adenomatous polyposis (D13.91) and benign neoplasm of ill-defined sites within the digestive system (D13.99). Familial adenomatous polyposis is an inherited disorder that is a predisposition to colon cancer.
Chapter 3 – Diseases of the Blood and Blood-Forming Organs and Certain Disorders Involving the Immune Mechanism
There are eight additions to Chapter 3. Six diagnosis codes have been added to sickle-cell disease to include dactylitis, which is a severe inflammation of fingers and toes. This condition is commonly seen in infants who have sickle-cell anemia. The new sickle-cell codes are D57.04 (Hb-SS disease with dactylitis), D57.214 (sickle-cell/Hb-C disease with dactylitis), D57.414 (sickle-cell thalassemia, unspecified, with dactylitis), D57.434 (sickle-cell thalassemia beta zero with dactylitis), D57.454 (sickle-cell thalassemia beta plus with dactylitis), and D57.814 (other sickle-cell disorders with dactylitis).
Schwachman-Diamond syndrome (D61.02) is another addition to this chapter. This condition is a genetic multi-system disorder in which the patient may exhibit exocrine pancreatic insufficiency and bone marrow failure. This code was presented at the ICD-10 Coordination and Maintenance Committee Meeting of March 2022. The last addition to the chapter is D89.84 (IgG4-related disease). This rare condition is a problem with the immune system.
Chapter 4 – Endocrine, Nutritional, and Metabolic Diseases
The diagnosis code E20.8 (other hypoparathyroidism) has been expanded to six new codes. These codes provide more specific types, such as autosomal dominant, secondary hypoparathyroidism, autoimmune, and hypoparathyroidism due to impaired parathyroid hormone secretion.
Three new codes have been added, including E74.05 (lysosome-associated membrane protein 2 [LAMP 2] deficiency), E75.27 (Pelizaeus-Merzbacher disease), and E75.28 (Canavan disease). The mutations that come with LAMP 2 cause myopathy, cardiomyopathy, and encephalopathy of Danon disease, according to the National Library of Medicine. Pelizaeus-Merzbacher disease is a rare, progressive, and degenerative central nervous system condition. Canavan disease is caused by a mutation of the ASPA gene. The brain degenerates into spongy tissue filled with small fluid-filled spaces.
The diagnosis code E79.8 (other disorders of purine and pyrimidine metabolism) has been expanded to include two specific diagnoses and other specified disorders of purine and pyrimidine metabolism (E79.89). The new codes are E79.81 (Aicardi-Goutières syndrome) and E79.82 (hereditary xanthinuria).
Metabolic syndrome (E88.81) has been expanded to include a sixth digit. Metabolic syndrome is now assigned to code E88.810. Insulin resistance has three new codes assigned – E88.811, E88.818, and E88.819.
The last code to be added to this chapter is E88.A (wasting disease [syndrome] due to underlying condition). This code was presented at the ICD-10 Coordination and Maintenance Committee Meeting of September 2022. The materials from this meeting state that the condition is an involuntary, on-going loss of more than 10 percent of body weight with reduction in muscle mass, with or without loss of fat due to an underlying condition.
Chapter 6 – Diseases of the Nervous System
Twenty-four codes have been added to this chapter. There are two deletions due to expansion of diagnosis codes. Parkinson’s Disease (G20) has been expanded to include with or without dyskinesia and with or without mention of fluctuations. Epilepsy has been expanded to include G40.C- (Lafora progressive myoclonus epilepsy) with or without intractable and with or without status epilepticus options. Chronic migraine with aura (G43.E-) has been added with options for intractable and status migrainosus.
Chapter 7 – Diseases of the Eye and Adnexa
This chapter has had expansion of retinal disorders due to diseases classified elsewhere (H36) to include nonproliferative and proliferative sickle-cell retinopathy (H36.8-) of specific eyes. Other additional codes include muscle entrapment (H50.6-) of the inferior oblique, lateral rectus, medial rectus, superior oblique, and extraocular muscles with the ability to specify the eye. Foreign body sensation (H57.8A-) has been added to the chapter.
Note: There are no changes to Chapters 5 and 8.
Chapter 9 – Diseases of the Circulatory System
Five revisions of code titles are in this chapter. Code I25.112 had a typographical error correction. Codes I71.51, I71.52, I71.61, I71.62 have been revised to specify thoracoabdominal aorta rather than abdominal aorta. I20.8 (other forms of angina pectoris) has been expanded to two codes to include more specificity. I24.8 (other forms of acute ischemic heart disease) has been expanded to include acute coronary microvascular dysfunction (I24.81) and other forms of acute ischemic heart disease (I24.89).
A new code for chronic coronary microvascular dysfunction can now be found in Chapter 9. Supraventricular tachycardia (I47.1) has been expanded to include supraventricular tachycardia, unspecified (I47.10), inappropriate sinus tachycardia, so stated (I47.11), and other supraventricular tachycardia (I47.19).
Chapter 10 – Diseases of the Respiratory System
There is one deletion and seven new codes in this chapter. The deletion of J15.6 (pneumonia due to other Gram-negative bacteria) is due to expansion to include Acinetobacter baumannii (J15.61) and other Gram-negative bacteria (J15.69). Three codes have been added for chronic lung allograft dysfunction (J4A.-). Additional codes have been added concerning chronic obstructive pulmonary disease, such as bronchiolitis obliterans and bronchiolitis obliterans syndrome (J44.81) and other specified chronic obstructive pulmonary disease (J44.89).
Chapter 11 – Diseases of the Digestive System
Codes K35.20 (acute appendicitis with generalized peritonitis, without abscess) and K35.21 (acute appendicitis with generalized peritonitis with abscess) have been expanded to include without abscess, with abscess, without perforation, and with perforation. Codes for small intestinal bacterial overgrowth have been added to include hydrogen-subtype (K63.8211), hydrogen sulfide-subtype (K63.8212), unspecified (K63.8219), fungal overgrowth (K63.822), and intestinal methanogen overgrowth (K63.829). Codes have been added for short bowel syndrome with descriptors for with or without colon in continuity as well as intestinal failure.
Note: No changes for Chapter 12
Chapter 13 – Diseases of the Musculoskeletal System and Connective Tissue
Eighteen codes have been added for age-related osteoporosis with current pathological fracture of the left, right, and unspecified pelvis (M80.0B-). Eighteen codes have been added for other osteoporosis with current pathological fracture of the left, right, and unspecified pelvis (M80.8B-).
Chapter 14 – Diseases of the Genitourinary System
There are seven new codes for recurrent and persistent immunoglobulin A nephropathy (N02.B-). The manifestations include glomerular lesion; focal and segmental glomerular lesion; diffuse membranoproliferative glomerulonephritis; diffuse membranous glomerulonephritis; diffuse mesangial proliferative glomerulonephritis; and mesangiocapillary glomerulonephritis.
Nephrotic syndrome (N04.2) has been expanded to include primary membranous nephropathy, secondary membranous nephropathy, and other nephrotic syndromes with diffuse membranous glomerulonephritis. Isolated proteinuria with diffuse membranous glomerulonephritis (N06.2-) has been expanded to include primary membranous nephropathy, secondary membranous nephropathy, and other isolated proteinuria.
There was one revision in this chapter. The descriptor of N35.812 has been revised from other urethral bulbous stricture, male, to other bulbous urethral stricture, male.
Chapter 15 – Pregnancy, Childbirth, and the Puerperium
Four codes have been added for Intrahepatic cholestasis of pregnancy (O26.64-). Postpartum kidney failure has been expanded to include hepatorenal syndrome following labor and delivery (O90.41), and other postpartum acute kidney failure (O90.49).
Chapter 16 – Certain Conditions Originating in the Perinatal Period
There was a title revision to P19.9 from metabolic acidemia, unspecified, to metabolic acidemia in newborn, unspecified.
Chapter 17 – Congenital Malformations, Deformations, and Chromosomal Abnormalities
Craniosynostosis (Q75.0-) has been expanded to include specific types including craniosynostosis, unspecified, unilateral (Q75.001); craniosynostosis, unspecified, bilateral (Q75.002); craniosynostosis, unspecified (Q75.009); sagittal craniosynostosis (Q75.01); coronal craniosynostosis (Q75.02-); metopic craniosynostosis (Q75.03); lambdoid craniosynostosis (Q75.04-); cloverleaf skull (Q75.051); pansynostosis (Q75.052); other multi-suture craniosynostosis (Q75.058); and other single-suture craniosynostosis (Q75.08).
There are new codes for Bardet-Biedl syndrome (Q87.83); Laurence-Moon syndrome (Q87.84); and MED13L syndrome (Q87.85). Bardet-Biedl and Laurence-Moon syndromes were presented at the ICD-10 Coordination and Maintenance Committee Meeting in March 2022. These conditions are disorders of obesity. MED13L was presented at the ICD-10 Coordination and Maintenance Committee Meeting in September 2022. This genetic condition is characterized by intellectual disabilities, heart malformation, and hypotonia.
The description of PTEN tumor syndrome has been updated to PTEN hamartoma tumor syndrome (Q85.81). Marfan’s syndrome description has been updated to Marfan syndrome (Q87.4-).
Chapter 18 – Symptoms, Signs, and Abnormal Clinical and Laboratory Findings, Not Elsewhere Classified
Four codes have been added for foreign body sensation of the circulatory and respiratory system (R09.A) with site specification. R40.2A (Nontraumatic coma due to underlying condition) is new. Thirteen new codes regarding dense breasts (R92.3-), mammographic fatty tissue density, mammographic fibroglandular density, mammographic heterogeneous density, or mammographic extreme density were added. These codes can be further specified regarding right, left, or bilateral breasts.
Chapter 19 – Injury, Poisoning, and Certain Other Consequences of External Causes
Twelve new codes for toxic effect of gadolinium (T56.82-) were added. These codes include a sixth character for accidental, intentional self-harm, assault, and undetermined. The seventh character describes initial encounter (A); subsequent encounter (D); and sequela (S).
Chapter – 20 – External Causes of Morbidity
There are 123 new codes in category W44 for various objects entering into or through a natural orifice. The objects include battery, button battery, plastic object, plastic bead, plastic coin, plastic toy, plastic bottle, glass, sharp glass, intact glass, magnetic metal, magnetic metal bead, magnetic metal coin, magnetic metal jewelry, non-magnetic metal object, non-magnetic metal bead, non-magnetic metal coin, non-magnetic metal toy, non-magnetic metal jewelry, natural/organic material, bezoar, rubber band, food, insect, audio device, combination metal/plastic toy, combination metal/plastic jewelry, other sharp object, needle, and knife. The seventh character will be the same as reported in Chapter 19.
Chapter 21 – Factors Influencing Health Status and Contact with Health Services
Observation and evaluation of newborn for other specified suspected condition ruled out (Z05.8-) has been expanded to include suspected condition related to home physiologic monitoring device ruled out (Z05.81) and other specified suspected condition ruled out (Z05.89).
New codes were added regarding carrier status (Z22.3-) to include carbapenem-resistant/sensitive Acinetobacter baumannii, Acinetobacter baumannii, and Enterobacterales.
Encounter for other specified prophylactic measures (Z29.8-) has been expanded to include encounter for HIV pre-exposure prophylaxis or other specified prophylactic measures. There are new social determinants of health (SDOH) codes for child in custody (Z62.2-), parent-child conflict (Z62.8-), and runaway (Z62.892).
There is an expansion for family history of colon polyps (Z83.71-) to include adenomatous/serrated polyps, hyperplastic polyps, and unspecified. There are additions to caregiver’s other noncompliance (Z91.A-) to include the description of due to financial hardship or due to other reason.
Note: There are no updates for Chapter 22
FY24 ICD-10-CM Guidelines
The FY24 ICD-10-CM Guidelines were published on July 5, with minimal update.
There is a new guideline in Chapter 9 (Diseases of the Circulatory System). Section I.C.9.e.6 (Myocardial Infarction with Coronary Microvascular Dysfunction), which states, “Coronary microvascular dysfunction (CMD) is a condition that impacts the microvasculature by restricting microvascular flow and increasing microvascular resistance. Code I21.B, Myocardial infarction with coronary microvascular dysfunction, is assigned for myocardial infarction with coronary microvascular disease, myocardial infarction with coronary microvascular dysfunction, and myocardial infarction with non-obstructive coronary arteries (MINOCA) with microvascular disease.”
Another important change in the ICD-10-CM guidelines this year is found in Section III (Reporting Additional Diagnoses). There is an update to the definition of “other diagnoses,” which is now interpreted as additional clinically significant conditions. The remainder of the changes include code changes to be consistent with the FY24 ICD-10-CM codes.
Additional Resources:
Centers for Disease Control and Prevention, Comprehensive Listing ICD-10-CM Files
Centers for Medicare and Medicaid Services, 2024 ICD-10-CM
ICD - ICD-10-CM - Coordination and Maintenance Committee (cdc.gov)
Laurie M. Johnson, MS, RHIA, FAHIMA, is currently a senior healthcare consultant for Revenue Cycle Solutions, based in Pittsburgh, PA. She has more than 40 years of experience in health information management and specializes in coding and related functions.