On April 27th CMS released the FY 2022 Inpatient Prospective Payment System (IPPS) proposed rule.[1] The Table below provides an outline of 153 proposed new ICD-10-CM codes, distributed across several chapters. Notable highlights for the proposed ICD-10-CM changes include new codes for:
- Immune effector cell associated neurotoxicity syndrome (ICANS) in category G92. ICANS is a clinical and neuropsychiatric syndrome that can occur in the days to weeks following administration of certain types of immunotherapy, especially immune effector cell (IEC) and T cell engaging therapies. It has previously been referred to as cytokine release encephalopathy syndrome (CRES) and chimeric antigen receptor T (CAR-T) cell-related encephalopathy or neurotoxicity. [2]
- Gastric intestinal metaplasia with and without dysplasia in category K31.A. Intestinal metaplasia is a condition in which the cells that create the lining of your stomach are changed or replaced. The replacement cells are similar to the cells that create the lining of your intestines. It’s considered a pre-cancerous condition. [3]
- Irritant contact dermatitis in category L24.
- Sjogren syndrome in category M35. Sjogren’s syndrome is an autoimmune disease that causes your immune system to go haywire and attack healthy cells instead of invading bacteria or viruses. [4]
- Abnormal findings on neonatal screening in category P09. Expansion of this category will provide more specific information regarding the type of screening with abnormal findings.
- Cannabis poisoning in category T40.7. The new codes will allow separate capture of cannabis poisoning versus synthetic cannabinoids.
Table: Outline of 153 Proposed New ICD-10-CM Codes
| Chapter | New Codes | Deleted Codes |
| 1 Certain infectious and parasitic diseases (A00-B99) | 1 | |
| 2 Neoplasms (C00-D49) | 3 | |
| 3 Diseases of the blood and blood-forming organs (D50-D89) | 5 | 1 |
| 4 Endocrine, nutritional and metabolic diseases (E00-E89) | 1 | |
| 5 Mental, Behavioral and Neurodevelopmental disorders (F01-F99) | 3 | 1 |
| 6 Diseases of the nervous system (G00-G99) | 10 | 1 |
| 9 Diseases of the circulatory system (I00-I99) | 1 | |
| 10 Diseases of the respiratory system (J00-J99) | 1 | |
| 11 Diseases of the digestive system (K00-K95) | 13 | 1 |
| 12 Diseases of the skin and subcutaneous tissue (L00-L99) | 8 | |
| 13 Diseases of the musculoskeletal system and connective tissue (M00-M99) | 25 | 3 |
| 16 Certain conditions originating in the perinatal period (P00-P96) | 9 | 1 |
| 18 Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R99) | 14 | 3 |
| 19 Injury, poisoning and certain other consequences of external causes (S00-T88) | 45 | 18 |
| 20 External causes of morbidity (V00-Y99) | 3 | |
| 21 Factors influencing health status and contact with health services (Z00-Z99) | 11 | 1 |
| Total | 153 | 30 |
End Notes:
1. FY 2022 IPPS Proposed Rule Home Page | CMS
2. Immune effector cell-associated neurotoxicity syndrome (ICANS) – UpToDate
3. Intestinal Metaplasia: Symptoms, Treatment, and Diet (healthline.com)
4. Sjogren’s Syndrome: Symptoms, Causes, Diagnosis, Treatment (webmd.com)