Coding Updates

The CDC’s National Center for Health Statistics announced that it will not hold a Spring Coordination and Maintenance (C&M) Committee Meeting for 2025. This meeting is normally held twice a year in the spring and the fall to discuss ICD-10 coding proposals.  The CDC website, states, however that this change will not affect the ICD-10-CM code updates that were approved in 2024 to be implemented in October.  We will watch closely for those!  There are no new ICD-10-CM codes for implementation on April 1st, 2025.  There were some updates to the tabular list. 

Here are a few to consider:

• There is a new “use additional code” note that instructs coders to report E88.A (Wasting disease [syndrome] due to underlying condition) for associated cachexia when applicable with code J65 (Pneumoconiosis associated with tuberculosis) and code categories (A15-A19) Tuberculosis and N18 (Chronic kidney disease [CKD]).
• K90.82 (Short bowel syndrome) now includes a new “Excludes 1” note for postsurgical malabsorption, not elsewhere classified (K91.2).
• Under the chapter header for Chapter 19: Injury, poisoning and certain other consequences of external causes (S00-T88), codes associated with birth trauma (P10-P15) and obstetric trauma (O70-O71) category are now an Excludes 2 from an Excludes 1. 
• The 7th character note for code category S06 (Intracranial injury) has been revised from “The appropriate 7th character is to be added to each code from category S06” to “The appropriate 7th character is to be added to each code from category S06, except as noted below”.

The CDC did release some guideline changes to be aware of that will take effect on April 1, 2025:

• A guideline for “obesity” was added at 1.C.4.b stating:
  • “The obesity codes in category E66, Overweight and obesity, include codes related to the cause of obesity, such as drug-induced obesity (E66.1), and codes related to effects of obesity, such as code E66.2, Morbid (severe) obesity with alveolar hypoventilation. There are other codes related to obesity in other categories of the classification, such as E88.82, Obesity due to disruption of MC4R pathway; and codes in fifth character subcategory O99.21, Obesity complicating pregnancy, childbirth, and the puerperium.”
• Additionally, a new guideline for “obesity class” was added at 1.C.4.b.1:
  • “The obesity class codes in subcategory E66.81, Obesity class, require a fifth character to convey the severity of obesity. The obesity class should be documented in the medical record by the provider for these codes to be assigned. The obesity class codes can be reported with other obesity codes in the classification found in Chapters 4 and 15 to fully describe the condition. However, if both class 3 obesity and morbid obesity are documented, only a code for class 3 obesity should be assigned as it is more specific.”

Guideline change for coding COVID-19:

• A guideline at 1.C.1.g.1.a for “Code only confirmed cases” was updated indicating that confirmed cases of COVID-19 must be documented by the provider. The statement “or documentation of a positive COVID-19 test result” has been removed from the updated guidelines an will now state:
  • “Code only a confirmed diagnosis of the 2019 novel coronavirus disease (COVID-19) as documented by the provider.”
• The guideline at 1.C.1.g.1.h for “Asymptomatic individuals who test positive for COVID-19” has also been updated and will read:
  • “For asymptomatic individuals who test positive for COVID-19 and there is no provider documentation of a diagnosis of COVID-19, query the provider as to whether or not the individual has COVID-19. A false positive laboratory test is possible, and it is the provider’s responsibility to confirm the diagnosis and document accordingly.”

The ICD-10-CM Official Guidelines for Coding and Report can be obtained using this link:  ICD-10-CM Guidelines-April-1-2025 2-20-25.

Contact MAC Legacy for your coding questions and service needs.