April 1 Update Includes New Diagnosis Codes, Procedure Codes, & MS-DRG 40.1 Grouper Software

April 1 Update Includes New Diagnosis Codes, Procedure Codes, & MS-DRG 40.1 Grouper Software

CMS released code files for ICD-10-CM and ICD-10-PCS codes that will take effect on April 1, 2023. The ICD-10 MS-DRG 40.1 Grouper Software and accompanying materials will be available on February 1, 2023.

April 1 Update is Now Routine

icd-10 ms-drg 40.1 grouper software

The 2022 Final Rule for the Inpatient Prospective Payment System (IPPS) established that there would be two regular updates to the codes and the MS-DRG system. The October 1 update that coincides with the federal fiscal year and an update on April 1 of a given year. The industry anticipated that the April 1 update would be less extensive than the October 1 version. Files for the codes and MS-DRG updates would be available by February 1 of a given year to allow time for system updates and education. This year, 42 ICD-10-CM and 34 ICD-10-PCS codes will take effect on April 1, 2023.

ICD-10-CM Diagnosis Codes

There are 42 new diagnosis codes, along with code note additions. All of the changes are in three chapters; 19, Poisoning and certain other consequences of external causes; 20, External causes of morbidity; and 21, Factors influencing health status and contact with health services. A guideline update (I.C.21.c.17) provides additional examples for using Social Determinants of Health codes.

Many of the changes are expansions of existing codes. For example, expanding subcategory Y07.01 Husband perpetrator of maltreatment and neglect to allow for the designation of current (Y07.010) or former (Y07.011) husband. CMS notes that the National Center for Health Statistics (NCHS) released these codes, “In an effort to better enable the collection of health-related social needs (HRSNs) defined as individual-level, adverse social conditions that negatively impact a person’s health or healthcare, are significant risk factors associated with worst health outcomes as well as increased healthcare utilization.”

The addendum files for the new codes, index updates, and revised guidelines are available at both the NCHS and CMS websites.

ICD-10-PCS Codes

There are 34 new ICD-10-PCS codes, bringing the total number of codes up to 78,530. The reference addenda include additions to body part, device, and device/substance/technology definitions. For example, the update adds the Space of Retzius definition to the Pelvic Cavity body part in the Medical and Surgical section.

The complete update, which includes code table, index, and reference addenda, is available at the CMS website.

ICD-10 MS-DRG 40.1 Grouper Software Information Coming Soon

Version 40.1 of the MS-DRG Grouper Software, Definitions Manual Table of Contents, and the Definitions of Medicare Code Edits will be released on February 1, 2023, and located on the CMS website.

This version update will accommodate the new diagnosis and procedure codes for discharges on or after April 1, 2023 (CMS).

The comprehensive review of the April 1, 2023 changes is now available on the YES HIM Education website.

Additional Resources on Coding Updates

Teri Jorwic

Contract Educator, MPH, RHIA, CCS, CCS-P, FAHIMA
ICD-10 MS-DRG 40.1 Grouper Software

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