It is that time of year again where the new codes for the next fiscal year and IPPS Final Rule are available. In this post, we will summarize the biggest changes for ICD-10-CM codes, ICD-10-PCS codes and IPPS changes for FY2024.
For FY2024 we have:
Most of the changes impacting the total number of new codes occurred in the external causes of morbidity and musculoskeletal system chapters. Also, many of the diagnosis changes involved expanded somewhat obscure condition codes, such as adding codes for sites for desmoid tumors, adding a choice of ‘with dactylitis” for all sickle cell disease codes and expanding types of metabolic syndrome codes. There are many other changes like this. Coders are encouraged to continue to utilize the index for coding to arrive at these newer expanded codes and to research the medical record for supportive documentation. Codes are only going to get more specific and accurate documentation is a must.
Significant Changes
There were some updates to the ICD-10-CM index involving cerebrovascular accident entries, arteriosclerosis with infarction entries added, and updates to correct code assignments such as those under Bronchitis, due to fumes and vapors. There were other index additions and changes as well. The following index and tabular changes are rather significant:
For FY2024 we have:
Changes this year for procedure codes are mostly in the medical surgical section and the new technology section. Coders must always be aware of body part value definition updates and additions along with device and substance additions to the tables. Usually these are added to the index as well. There were many added as usual this year.
Significant Changes
The IPPS Final Rule 2024 was out on August 1, 2023. Acute care hospitals that report quality data and that are meaningful users of EHRs will receive approximately a 3.1% increase in Medicare operating rates. This reflects the projected hospital market basket update of 3.3 percent reduced by a 0.2 percentage point productivity adjustment. Hospitals that do not submit quality data would lose 1/4 of the market basket update (of 3.1% as above) This would be 2.33% increase only. Hospitals that are not meaningful users of EHRs will be subject to a 3/4 or -0.75 reduction of the market basket for FY 2024. CMS is projecting that with the 3.1% increase and other changes to IPPS policies it will increase total IPPS payments in FY2024 by roughly $2.2 billion which includes increase in operating payments but decrease in new technology payments.
The “New COVID-19 Treatments Add-on Payments” (NCTAP) end on 9/30/23.
Quality measure additions and changes summary are included in our course on IPPS Changes for FY2024.
Of note, CMS is changing “Homelessness” SDOH codes (Z59.00, Z59.01, Z59.02) from Non-CC to CC. CMS is recognizing homelessness as an indicator of increased resource utilization in the acute inpatient hospital setting. CMS is also considering including social determinants of health (SDOH) as part of new quality measures.
In the Final Rule, CMS created 15 new MS-DRGs and deleted 16 MS-DRGS. This is because some existing MS-DRGS were expanded to include with CC, with MCC, and without CC/MCC. The majority of MS-DRG changes are in MDC-5, Diseases and Disorders of the Circulatory System. There were several reassignments of MS-DRGs for procedures that make more sense. One example is changing central and retinal branch artery occlusion diagnosis codes from MS-DRG 123 Neurological Eye disorders to MS-DRGs 124 and 125 Disorders of eye with MCC or thrombolytic administration or Without MCC along with adding procedure code 3W0—17 for thrombolytic agent to DRG 124.
In another change, CMS deleted old MS-DRGs 246-249 for Percutaneous CV procedures involving bare stents and drug eluting stents and eliminated the division based on type of stents. The new MS-DRGS are 321/322 Percutaneous CV procedures with intraluminal device with MCC OR 4+ arteries/intraluminal devices or without MCC.
In all, there were 10 changes made similar to the above two regarding MS-DRGs. As for unrelated MS-DRGS, five different procedures were moved OUT OF MS-DRGS 981-983 into their proper chapter MS-DRGs.
The MCC and CC lists were only modified to accommodate the new codes and expansion of old codes. There were no existing codes added or removed from the lists with the exception of adding Z59.00 codes for homelessness as CCs.
As for New Technology Add on Payments (NTAP) there were 11 NTAP payments continued from last year. There was a total of 19 new approvals for NTAP payments for 2024 bringing the total to 30. In HIA’s course IPPS Changes for FY2024 we have a complete listing with information about the new technology, codes applicable and payment for coders to reference.
Our three new courses below are available for purchase on HIALearn.com! You don’t want to miss taking these courses. These courses provide much more detail of ALL of the changes for FY2024 and include explanations, photos, and descriptions to assist the coder in applying the new codes.
The information contained in this post is valid at the time of posting. Viewers are encouraged to research subsequent official guidance in the areas associated with the topic as they can change rapidly.