ICD-10 System Codes Will See New Updates by October 1

April 13, 2016 - The ICD-10 implementation deadline and postponements brought a variety of challenges to the healthcare field. One of those obstacles has been the constant ICD-10 system code freezes. However, on October 1, 2016, the healthcare industry will move toward the standard cycle of annual updates, reports the Journal of AHIMA.

In early March, the ICD-10 Coordination and Maintenance committee came together to decide on proposals for the ICD-10-CM and ICD-10-PCS to be transitioned into the October 1, 2017 ICD-10 system agenda. Representatives from the Centers for Medicare & Medicaid Services (CMS) including Pat Brooks, Senior Technical Advisory at CMS, offered recommendations during the March 9 committee meeting for effective finalized code descriptions, the Journal of AHIMA explained.

Brooks also mentioned that the ICD-10 implementation went very well over the last six months. CMS was seeking public written comments regarding the development of the new ICD-10-PCS. The proposed rule for the ICD-10 system will be published later this month and the final rule is going to be released by August 1, 2016.

The ICD-10 Coordination and Maintenance Committee has the ability to review ICD-10-PCS codes that were already approved and revised. Currently, there are 3,651 new codes and 487 revised codes that will be part of the October 1, 2016 update.

More than 3,000 of the new codes are related to the cardiovascular system including adding unique medical device values and identifying specific body parts. The number of blood vessels are considered alongside with “the specification of the descending thoracic aorta.”

The meeting of the ICD-10 Coordination and Maintenance Committee involved discussing 13 new ICD-10-PCS proposals, which would be relevant for fiscal year 2017. Certain codes revolving around knee replacement and lower joint surgeries are also included.

Additionally, there were 24 diagnostic changes up for discussion on March 9. For example, the Zika virus was outlined and whether a new code would be created for this diagnosis. When it comes to myocardial infarction, different codes may be included to specify the types in accordance with a handful of cardiology establishments.

“The procedure and diagnosis agendas include a timeline that specifies dates for the committee meetings, due dates for comments, dates for submitting code proposals, and when the proposed and final addenda is published as well as links needed to access related documents,” The Journal of AHIMA clarified.

“All the proposals presented at the Coordination and Maintenance committee meeting are still proposals – nothing is finalized. There is a public comment period where all comments are submitted in writing to be reviewed by CMS and CDC before final decisions are made.”

“Comments on codes for the FY 2018 addenda are due by May 6, 2016. This is your opportunity to participate in the process and have input on the codes before they are finalized into an addendum. Take the time to review the proposals and addenda and send in your thoughts. HIM coding professionals who work with the codes on a daily basis can give invaluable input on the code itself as well as the use and application of proposed codes that can assist in ensuring accurate data is obtained,” AHIMA advised.

Last month, CMS alongside the Centers for Disease Control and Prevention announced that they had added more than 5,000 new diagnosis codes to the ICD-10 system. These codes will be used next year among providers when filing claims data.

More than 3,000 of these codes are meant specifically for specifying inpatient procedures by 2017. The number of diagnostic codes has risen dramatically because previously there were code freezes taking place due to the pressures surrounding the ICD-10 implementation deadline.

However, the ICD-10 claim denial rate has remained relatively low among most healthcare providers since the ICD-10 implementation deadline took hold on October 1, 2015. RelayHealth Financial, for example, has shown an ICD-10 claim denial rate of only 1.6 percent among 262 million medical claims.

The majority of hospitals and medical facilities have not had significant issue with maintaining their revenue at optimal levels after the ICD-10 implementation deadline passed. This may be due to the stress that CMS put on transitioning to the new coding system including the many resources and extra time afforded to providers to implement ICD-10 diagnostic codes because of the prior delays.

CMS reported that its ICD-10 claim denial rate was only at 0.07 percent during the last three months of 2015. An additional 0.07 percent of ICD-9 claims were also rejected during the same period of time.

However, when it comes to total claims rejected, CMS did deny 9.9 percent of claims during the fourth quarter of 2015. For more information regarding how to keep healthcare revenue strong in the midst of the ICD-10 implementation, click here to learn about CMS advisements for ICD-10 success.