On April 1, your revenue cycle will have additional diagnosis code options to further capture social determinants of health.

The CDC just released upcoming changes to both the ICD-10-CM diagnosis code set and the official coding guidelines.

The new changes include 42 diagnosis code additions, seven deletions, and one code revision. All changes will go into effect April 1, which should give revenue cycle leaders time to train staff and update their coding systems.

A new social determinants of health (SDOH) code for reporting problems related to education and literacy is among the code additions. As a reminder, SDOH are social factors, such as homelessness, illiteracy, a history of childhood trauma, and joblessness or underemployment, that can affect a person’s health.

Also added are codes to update the verbiage related to critical perpetrator of abuse external cause codes with that of current CDC core data collection elements and literature related to patient maltreatment and neglect — including elder abuse.

There is also a slate of new codes pertaining to “financial abuse” of adults and children. For example, the April update brings a code for adult financial abuse, confirmed, initial encounter and a code for child financial abuse, confirmed, initial encounter.

The ICD-10-CM Official Guidelines for Coding and Reporting have been expanded to provide more examples in the SDOH section.

For example, if a patient who lives alone suffers an injury that temporarily impacts their ability to perform activities of daily living, it would be appropriate to include a diagnosis code for problems related to living alone, the guidelines say.

The updated guidelines emphasize that the SDOH should connect directly to the episode of care.

These updates don’t come as a surprise as there has been a spotlight on reporting SDOH.

With increasing attention on population health and quality initiatives, organizations have turned their focus on SDOH and how capturing those ICD-10-CM codes impacts their patient population and their success in caring for that population.

As your middle revenue cycle works to report SDOH more accurately, a recent study is now showing what can be learned from reporting these diagnosis codes appropriately.

As HealthLeaders previously reported, a study published in JAMA Network Open found that coded housing instability is linked to higher hospital admission rates for mental disorders, longer inpatient stays, and substantial healthcare costs.

Because coding occurs mid-cycle, it provides an opportunity to catch errors introduced earlier in the process, as well as preventing similar errors in the future.

Staying abreast of these regulatory coding updates is important for revenue cycle leaders as coding—and its completeness and accuracy—has a profound impact on an organization’s bottom line.

Amanda Norris is the Revenue Cycle Editor for HealthLeaders.


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