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Return of Annual Updates to ICD-10 Code Set Begin Oct. 1

With the lifting of the ICD-10 code set freeze, regularly scheduled annual updates are coming.

By Kyle Murphy, PhD

- At a recent meeting of the ICD-10 Coordination & Maintenance Committee, the Centers for Medicare & Medicaid Services unveiled plans for implementing the first updates to the ICD-10 code set.

CMS, CDC discuss first updates to ICD-10 code set

Last week's meeting was the first since the ICD-10 implementation deadline on October 1, which ICD-10 Coordination and Maintenance Committee Co-Chair labeled a success.

"We're so pleased to report that no sky fell and there were no major issues. We had no big billing problems. And life is good," she said to kick off the two-day public forum in Baltimore to discuss proposed code changes to ICD-10 codes.

On the subject of ICD-10 updates, the first additions to ICD-10 codes will come on Oct. 1, 2016 as no requests for updates were made at a previous meeting of the committee back in October 2015.

"If we had planned to have an April 1 code update, then we would have had to have a request at the September Coordination & Maintenance Committee meeting for an expedited code update," she explained. "If we had, we would have made that decision by now. There were no requests for an April 1 code update at the September meeting; therefore, there won't be any updates until October 1, 2016."

As Brooks went on to explain, the "longer than expected" code freeze that went into effect as a result of repeated ICD-10 delays has thawed. Regular, annual updates to ICD-9 and ICD-10 codes were paused after Oct. 1, 2011, and only limited code updates occurred in subsequent years on the same date.

Despite the code freeze, ICD-10 Coordination & Maintenance Committee continued to meet twice annually to gauge the public's interest in requesting new diagnosis or procedure codes. Evaluations of those requests were similarly delayed until the partial freeze ended.

The proposed rule specifying the first updates to ICD-10 codes is slated to be published next month. The final rule will be published in August and code updates implemented on October 1. The public has until April to submit comments on the proposed code updates covered in this week's meeting. Additionally, a complete code update and addendum will appear in June.

On the ICD-10-PCS side, a total of 3651 new and 487 revised codes are currently under review, pushing the total number of ICD-10-PCS codes to 75,625 in fiscal year 2017.

Of the new codes, 97 percent pertain to cardiovascular system codes — 3549 new codes. The lion's share of the proposal for new codes came as a result of a new for unique device values for multiple intraluminal devices and related means for documenting arterial conditions.

While the diagnosis codes are few in number, they also include numerous deletions, according to Donna Pickett, MPH, RHIA, of the Centers for Disease Control.

"For the diagnosis side, we're looking at about 1900 new codes, and that would also include 313 deletions and 351 revised codes," she said during the second day of the public forum.

Pickett noted that the much longer code set freeze saw 162 proposals made. "Yes, quite a bit," she added.

"Interestingly, if you're wondering why things are progressing as they are," she continued, "there were a number of proposals that were presented early on in the cycle, for instance 2012, and in subsequent years during the freeze additional proposals came in and either revised what was already presented, others were withdrawn, others were amended, and then there were some that were very complex that required multiple re-presentations. Most of you who follow the process know which ones those are."

Unsurprisingly, the four-year freeze means a lot of work to work through the backlog while at the same time considering new proposals.

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