ICD-10-CM Updates: What RDNs Need to Know About New Codes

Note: Revisions to the codes have been made since they were originally released by the CDC in September 2024; the most current list of codes are outlined below.

The approved 2024 ICD-10-CM codes went into effect on October 1, 2024, and will be in use until September 30, 2025. This update includes 395 new diagnosis codes, 25 deletions, and 13 revisions, with several changes relevant to registered dietitian nutritionists. These updates aim to align with contemporary professional guidelines, help reduce under coding and improve data capture for health care claims. This update also includes new and more precise coding for adult and childhood obesity. Additionally, updates include expanded codes for disordered eating (anorexia nervosa, pica and rumination disorder in adults), hypoglycemia and pre-symptomatic Type 1 diabetes mellitus.

The ICD-10-CM code set is a fundamental tool for all health care providers, including RDNs. Developed by the World Health Organization (WHO), ICD-10-CM is used worldwide to classify diagnoses, conditions and related health issues. The “10” signifies the 10th revision, while “CM” stands for Clinical Modification. In the United States, the ICD-10-CM code set is maintained by the Centers for Disease Control and Prevention's National Center for Health Statistics, with updates occurring twice a year — on April 1 and October 1. This comprehensive coding system covers a wide range of health-related factors, including diseases, health conditions, symptoms, injuries, external causes and social determinants of health. For RDNs, understanding and using the ICD-10 codes is crucial, as they influence reimbursement, policy development and resource allocation.

New ICD-10-CM Codes for Adult and Childhood Obesity

The new ICD-10-CM diagnosis codes (Class 1: E66.811, Class 2: E66.812, and Class 3 E66.813) for adult and childhood obesity will enhance accuracy in obesity classification. For accurate diagnosis and treatment options in children and adolescents with obesity, health care providers should use the new E-codes alongside the new childhood Z-codes (Z68.54, Z68.55, Z68.56). Additionally, these codes promote the use of clinically relevant terms that help reduce weight stigma.

RDNs’ Scope of Practice with ICD-10 Codes

RDNs do not have the authority to assign medical diagnoses. RDNs should only use ICD-10 codes when assigned by a physician or other qualified health care provider. An exception to this rule is the use of Z codes, which are not diagnostic and are used to document factors impacting health status. Often Z codes need to be paired with another ICD-10 code for billing and reimbursement purposes. It’s important for RDNs to validate all diagnoses and corresponding ICD-10 codes before including them in their documentation or health care claims.

How to Use the New Z Codes and Their Relevance to RDNs

Codes in the Z00-Z99 family, also known as Z codes, are crucial for RDNs in documenting factors influencing health status and interactions with health services. Unlike other ICD-10 codes, Z codes do not necessarily denote a disease but represent instances where treatment or intervention is appropriate, even without a specific diagnosis. For example, Z codes can document social determinants of health, such as housing instability or food insecurity, which significantly affect nutrition and overall health outcomes.

One notable Z code for the profession is Z71.3, which is used to document dietary counseling and surveillance. Since Z codes are not associated with a medical diagnosis, RDNs may be able to assign them independently. However, before doing so, RDNs should carefully review payer policies to understand how using these codes might impact reimbursement for services.

Best Practices and Considerations for RDNs

RDNs should be familiar with payer policies regarding ICD-10 code updates, as insurance companies may implement code changes on different schedules. Understanding these nuances can prevent claim denials and reduce administrative burdens. While the ICD-10-CM system is updated twice a year, RDNs must recognize that payers may not adopt changes immediately, so it is crucial to stay informed about any delays or updates that might affect claims processing.

By keeping abreast of updates to the ICD-10 code set and understanding its structure and function, RDNs can enhance the accuracy of their medical records and billing while also improving patient care and providing outcome data. To learn more about ICD-10 codes, Academy members can watch the Power of Payment video “An Introduction to ICD-10 Codes” available on the Payment section of eatrightPRO.org. A full list of ICD-10 codes is available on the Centers for Medicare & Medicaid Services website and the CDC website.

Content from this article is featured in the Academy of Nutrition and Dietetics' MNT Provider newsletter and the September 2024 Payment and Reimbursement Affinity Group meeting.