CDC: New Diagnostic Codes Changes 2022

The guidelines for using code subcategory Z28.31 in the ICD-10-CM table state that "These codes should not be used for individuals who are not eligible for COVID-19 vaccines, as determined by the healthcare practitioner." Meanwhile, healthcare providers can use code Z28.310, "Unvaccinated for COVID-19," when the patient has never received a dose of the COVID-19 vaccine.

During a visit, a clinician may assign the code Z28.311, "Partially vaccinated for COVID-19," to a patient who has received at least one dose of the multidose COVID-19 vaccine regimen but has not received all the doses required to qualify as "fully vaccinated" under CDC guidelines. 

Among the inclusion criteria for Z28.39 are delinquent immunization and lapsed immunization schedule status. Due to their non-comorbid conditions (non-CC), the three new codes above will not impact the MS-DRG calculation. You can also find the index and tabular addenda for the new ICD-10 diagnosis codes list on the CDC's website. 

The following seven new ICD-10 procedure codes have been implemented on April 1, 2022 for treatments and vaccines covered by COVID-19 —

New ICD-10 Procedure Codes for COVID-19 Therapeutics and Vaccines

The following information are the other changes effective April 1, 2022:

• The CMS has updated the Medicare Code Editor's (MCE) and added a new MCE for "unspecified" ICD-10-CM diagnosis codes where there are other diagnosis codes that further specify the anatomical site in that code subcategory.

• To ensure that the following 3 procedure codes are removed from the Noncovered Procedure List and Limited Coverage Procedure List, the National Coverage Determination (NCD) for Artificial Hearts and Related Devices has been updated:
   
• 02RK0JZ (Replacement of right ventricle with synthetic substitute, open approach);
• 02RL0JZ (Replacement of left ventricle with synthetic substitute, open approach); and
• 02WA0JZ (Revision of synthetic substitute in heart, open approach)

Two codes were removed from the Limited Coverage Procedure List for the Ventricular Assist Devices:
 

• 02HA0QZ (Insertion of implantable heart assist system into heart, open approach); and
• 02WA0QZ (Revision of implantable heart assist system in heart, open approach).

Two procedure codes were also removed from the Noncovered Procedure List for Ventricular Assist Devices:
 

• 02WA3QZ (Revision of implantable heart assist system in heart, percutaneous approach); and
• 02WA4QZ (Revision of implantable heart assist system in heart, percutaneous endoscopic approach).

The introduction or infusion of therapeutics, including vaccines for COVID-19 treatment, has been coded under two new codes —

Addition of 2 codes to V39.1, Medicare Severity Diagnosis Related Groups (MS-DRGs)



How to Prepare for These New Diagnostic Code Changes in 2022?

Take a moment to consider these tips:

• Check the codes and their descriptions. Once you have a better understanding of the codes, you can educate physicians about them.
• Are there any denials due to codes that aren't specified, or do you use codes that have been deleted? Remember your mistakes, and avoid repeating them. 
• Maintain a high level of awareness of new codes for COVID-19 vaccines and other guidelines that can affect revenue and data integrity.

Partner with DrCatalyst

The trend of outsourcing medical coding is widespread in healthcare today, and it is on par with the new industry trends. With the help of Drcatalyst, you can easily integrate the new codes into your practice software, use the codes appropriately, and keep up with any changes to coding guidelines. You can also rely on us for cost-effective solutions in medical billing and coding. Give us a quick call, and we'll get you started!

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