2024 ICD-10-CM Coding Guidelines

The healthcare industry is constantly evolving, and with it, the tools and guidelines our medical billing services rely on for accurate documentation and coding. The latest update from the Centers for Medicare and Medicaid Services (CMS) and the National Center for Health Statistics (NCHS) brings us the “2024 ICD-10-CM Guidelines,” a comprehensive document outlining the coding and reporting guidelines for the fiscal year 2024, effective from April 1 to September 30, 2024. Here we dive into the key changes and updates that healthcare providers and coders need to be aware of.

What’s New in the FY 2024 Guidelines?

The FY 2024 ICD-10-CM guidelines come with several updates designed to enhance coding accuracy and clarity. Here’s what’s new:

Emphasis on Narrative Changes and Formatting

  • Narrative Changes: Updates are highlighted in bold text, making it easier to spot new and revised guidelines.
  • Movement of Items: Items that have been relocated within the guidelines are underlined, helping users track changes in the organization.
  • Heading Revisions: Italics indicate changes to headings, ensuring that users are aware of modifications in the structure and content.

Approval and Purpose

The guidelines have been meticulously reviewed and approved by leading organizations, including the American Hospital Association (AHA), the American Health Information Management Association (AHIMA), CMS, and NCHS. They serve as a companion to the official ICD-10-CM version, providing additional instructions and conventions to support accurate coding.

Comprehensive Guidelines

The document is structured into sections that cover general coding guidelines applicable across the board, as well as chapter-specific guidelines tailored to specific conditions and diseases. This structure ensures that coders have clear instructions for every scenario, from outpatient coding to reporting additional diagnoses in non-outpatient settings.

Detailed Coding Instructions

The guidelines offer detailed instructions on various aspects of coding, including:

  • Use of Codes: Guidelines on reporting purposes, placeholder characters, and the significance of the 7th character.
  • Abbreviations and Punctuation: Clarifications on the use of abbreviations, punctuation, and terms like “and” versus “with.”
  • Notes and Conventions: Instructions on interpreting “Includes,” “Excludes,” and “Code also” notes, among others.

Chapter-Specific Guidelines

For diseases and conditions ranging from infectious diseases to congenital malformations, the guidelines provide specific coding rules. Highlights include:

  • COVID-19 Coding: Special considerations for coding COVID-19 infections in pregnancy, childbirth, and newborns.
  • Chronic Conditions: Detailed coding instructions for chronic conditions like diabetes mellitus and chronic kidney disease.
  • Pregnancy and Childbirth: Guidelines for coding conditions related to pregnancy, childbirth, and the puerperium.

Why These Updates Matter

The FY 2024 ICD-10-CM coding guidelines are more than just a set of rules; they are a critical tool for ensuring accurate and consistent documentation across the healthcare industry. By adhering to these updated guidelines, healthcare providers and coders can enhance the quality of patient care, streamline billing processes, and ensure compliance with regulatory standards.


The “2024 April 1-ICD-10-CM Guidelines” mark a significant step forward in our ongoing effort to improve healthcare documentation and coding practices. By familiarizing themselves with these updates, healthcare professionals can continue to provide high-quality care while navigating the complexities of medical coding and billing.

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