ICD Updates

Practicefirst would like to notify its clients of the following ICD updates from CMS.

ICD-10 MS-DRGs Version 39.1 Effective April 1, 2022

In response to the ongoing national emergency concerning COVID-19, the Centers for Disease Control and Prevention’s (CDC) National Center for Health Statistics (NCHS) is implementing 3 new diagnosis codes, Z28.310, Z28.311 and Z28.39, into the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM), for reporting COVID-19 vaccination status effective April 1, 2022.

The ICD-10 MS-DRG Grouper assigns each case into an MS-DRG based on the reported diagnosis and procedure codes and demographic information (age, sex, and discharge status).

The ICD-10 MCE Version 39.1 uses edits for the ICD-10 codes reported to validate correct coding on claims for discharges on or after April 1, 2022.

The ICD-10 MS-DRG Grouper software package to accommodate these new codes, Version 39.1, is effective for discharges on or after April 1, 2022.

Assignment of new ICD-10-CM diagnosis codes Z28.310, Z28.311 and Z28.39, is as follows:

Diagnosis Code Description

Z28.310 Unvaccinated for COVID-19 

Z28.311 Partially vaccinated for COVID-19 

Z28.39 Other underimmunization status 

The ICD-10 MS-DRG V39.1 Grouper Software, Definitions Manual Table of Contents and the Definitions of Medicare Code Edits V39.1 manual will be available at https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/MS[1]DRG-Classifications-and-Software.html

The Index and Tabular Addenda for new diagnosis codes Z28.310, Z28.311, and Z28.39 will be available via the CDC website at: https://www.cdc.gov/nchs/icd/icd10cm.ht  

https://www.cms.gov/outreach-and-educationoutreachffsprovpartprogprovider-partnership-email-archive/2021-12-02-mlnc#_Toc89267941

For Coding questions, please contact our Coding Managers, Vidya Baliga at vidyab@pracfirst.com and Kelly Cole at kellyc@pracfirst.com or at 716-389-3262.