 The new guidelines become effective October 1, 2022, which is right around the corner. With multiple updates and clarifications to specific guidelines, the time is now for review and coder education!  If you haven’t already, it is certainly recommended to start your review now of the Official Guidelines for Coding and Reporting for fiscal year 2023, which reflect the new ICD-10-CM codes as of effective date, Oct. 1. The many updates implemented have provided further clarification in various areas for greater specificity and room for code expansion. We are never supposed to read between the lines, though often there are questions in clarification. One example of this is assigning the underdosing code in relation to a change in the patient’s condition. With this update, we now know a change is not required, as initially, the guidelines could be interpreted differently, with confusion as to whether this code could be used if there was no change in the patient’s condition. This example can be found under Chapter-Specific Coding Guidelines, Chapter 19: (e.) (c) Underdosing; Underdosing refers to taking less of a medication than is prescribed by a provider or a manufacturer’s instruction. Discontinuing the use of a prescribed medication on the patient's own initiative (not directed by the patient's provider) is also classified as an underdosing. For underdosing, assign the code from categories T36-T50 (fifth or sixth character “6”) Documentation of a change in the patient’s condition is not required in order to assign an underdosing code. Documentation that the patient is taking less of a medication than is prescribed or discontinued the prescribed medication is sufficient for code assignment. This is just one example of the many updates and changes, be sure to read the updated ICD-10-CM Guidelines and ensure an understanding amongst coder teams. With all changes in bold, the reader can easily distinguish what is newly added or edited, though with the volume of changes additional training may be required. Access guideline changes in this link, and get ahead of the game, educate coders and be ready for the October effective date - Its right around corner! If you need coding support or more help with understanding ICD-10 guidelines, contact an Axea Solutions coding subject matter expert advisor. An Axea advisor can assist your team with understanding new guidelines and provide targeted training in needed areas to reduce errors.
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