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Analysis

FY 2021 IPPS Proposed Rule Includes 600 Potential Code Changes

By Revenue Cycle Advisor  
   May 18, 2020

The entire list of proposed changes to ICD-10-CM/PCS codes is available in tables 6A-6K and 6P.1a-6P.4a of the rule.

A version of this article was first published May 18, 2020, by HCPro's Revenue Cycle Advisor, a sibling publication to HealthLeaders.

CMS released the fiscal year (FY) 2020 Inpatient Prospective Payment System (IPPS) proposed rule May 11, which includes just shy of 600 ICD-10-CM code changes. Proposed changes include 490 code additions, 47 revisions, and 58 invalidations, slated to go into effect October 1.

Related: CMS Considers New Price Transparency Requirements in FY 2021 IPPS Proposed Rule

The proposed changes include new ICD-10-CM codes in the following categories:

  • D57, sickle-cell disorders
  • D89, other disorders involving the immune mechanism, not elsewhere classified
  • F19, other psychoactive substance related disorders, as well as categories F10-F15
  • H18, other disorders of cornea
  • M05, rheumatoid arthritis with rheumatoid factor
  • M06, other rheumatoid arthritis
  • M08, juvenile arthritis
  • M19, other and unspecified osteoarthritis
  • R51, headache
  • S20, superficial injury of thorax
  • T40, poisoning by, adverse effect of and underdosing of narcotics and psychodysleptics (hallucinogens)
  • V00-V06 for electric scooter and other micro-mobility pedestrian conveyance injuries

Related: 2021 IPPS Proposed Rule: CMS Proposes Increased Payment Rates, New MS-DRG for CAR-T

Proposed ICD-10-CM code deletions include:

  • Some H18 corneal dystrophy codes because of the proposed expanded additions
  • R51 because of proposed specified headache additions
  • Some T40 codes for poisoning due to proposed specified additions

Related: Is IPPS Obsolete?

Proposed revised ICD-10-CM codes include:

  • Z68 (body mass index) codes relating to both adult and pediatric body mass index
  • Z88 (allergy status to drugs, medicaments, and biological substances) codes

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