ICD-10-CM: FY 2022 Guidelines Changes are Substantial


By Lynn Kuehn, MS, RHIA, CCS-P, FAHIMA

The ICD-10-CM Official Guidelines for Coding and Reporting FY 2022 have arrived and bring us 30 changes and updates, with many being significant. Coders are advised to review and understand the changes to the guidelines and be ready to apply them for discharges starting October 1, 2021.

What are Guidelines?
The ICD-10-CM Official Guidelines for Coding and Reporting are a set of rules that accompany and complement the official conventions and instructions provided within the ICD-10-CM classification system. Adherence to these guidelines when assigning ICD-10-CM diagnosis codes is required in all care settings under HIPAA.

As always, the instructions and conventions of the classification take precedence over the guidelines.

What is new for FY 2022?
Every year, the changes to the guidelines are a combination of good data practices (what I usually think of as housekeeping) and changes necessary to keep up with the dynamic changes occurring in healthcare and medicine. This year is no exception.

  • As expected, the guidelines identify how to code residuals of COVID-19. The guidelines clarify that the history of COVID-19 code is only assigned when there are no residuals or sequela of the disease.
  • Probably the biggest change incorporated in the new guidelines is the change to allow coding of long term use of insulin, oral anti-hyperglycemic drugs, and injectable anti-diabetic drugs together for patients who are using all three types of drugs to control their blood sugar levels. This approach is increasingly common and up to now the guidelines kept us from coding all of these together.
  • This year’s guidelines stress the use of codes for Social Determinants of Health (SDoH), those conditions in the environments that affect a wide range of health, functioning, and quality-of-life outcomes and risks. SDoH situations are identified in categories Z55 to Z65.
  • Also new (and a very helpful change) is guidance on when documentation from clinicians other than the patient’s provider can be used to support coding.

What else do I need to know?
Understanding the changes to the codes within the coding system for FY 2022 is only half the story. Coders need to master the changes to the guidelines as well. Taking the time now to master both code changes and guideline changes will ensure a smooth implementation of the FY 2022 code set.

All of the details on these and other significant changes to the guidelines for FY 2022 have been incorporated into the FY 2022 ICD-10-CM Update course from Libman Education.

 

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About the Author

Lynn Kuehn, MS, RHIA, CCS-P, FAHIMA
Lynn Kuehn is president of Kuehn Consulting, LLC, and a nationally recognized authority on ICD-10-PCS coding. Lynn was elected to the AHIMA Board of Directors, served as faculty for the original ICD-10 “Train-the-Trainers” program, and authored or co-authored several of AHIMA’s most popular books including ICD-10-PCS: An Applied Approach, recognized as the “go-to” resource for learning and mastering ICD-10-PCS. As a Subject Matter Expert with Libman Education, Lynn’s unique and engaging teaching methods as well as her leadership on the importance of accuracy and efficiency in coding is recognized by clients and students throughout the country.

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