Medical Billing and Coding Healthcare Blog

The Centers for Medicare & Medicaid Services (CMS) and Centers for Disease Control and Prevention (CDC) have announced they will add about 1,900 diagnosis codes and more than 3,600 hospital inpatient procedure codes to the ICD-10 coding system for claims in FY 2017.

To access the new procedure coding system codes, visit the CMS website.

The new diagnosis codes will be included in the hospital inpatient prospective payment system (IPPS) proposed rule for FY 2017. It is expected to be released next month.

The American Hospital Association, in AHA News Now, indicated that, "The large number of new codes is due to a partial freeze on updates to the ICD-10-CM and ICD-10 PCS codes prior to implementation of ICD-10 on Oct. 1, 2015."

Summary of ICD-10-PCS Updates

According to the agenda from a recent ICD-10 Coordination and Maintenance Committee meeting, there are a total of 75,625 valid ICD-10-PCS codes for the FY 2017 update as of March 9. This includes 3,651 new codes which will be added, and 487 code titles which will be revised.

Of the codes added, 3,549 new codes (97% of the total update) are cardiovascular system codes. Of the new cardiovascular system codes, 3,084 new codes (84% of the total update) resulted from a group of proposals to create unique device values for multiple intraluminal devices and to apply the qualifier bifurcation to multiple root operation tables for all artery body part values.

Other cardiovascular system proposals include more specific body part values for the thoracic aorta, specific table values that uniquely capture congenital cardiac procedures, and codes involving placement of an intravascular neurostimulator.

All code titles revised are in the heart and great vessels body system, and result from changing coronary artery number of sites to specify number of vessels, and modifying the previously non-specific thoracic aorta body part to specify descending thoracic aorta.

Other proposals that resulted in new codes are in the lower joint body systems, for expanding the body part detail available in the root operations removal and revision, and adding unique codes for unicondylar knee replacement.

There are also new codes for intracranial administration of substances (such as the Gliadel chemotherapy wafer) using an open approach. There are planned new codes for face transplant, hand transplant and donor organ perfusion.

Summary of Diagnosis Codes Updates

A summary report of the diagnosis part of the March 10 ICD-10 Coordination and Maintenance Committee meeting report is not yet available. To view the CDC diagnosis agenda, which discusses diagnosis codes changes, click here.

Note: For assistance with ICD-10 coding, bookmark the free ICD-10 tools provided by PGM Billing, a leading medical billing outsourcing company. PGM, which provides a wide range of billing services, including lab billing and mental health billing, offers an ICD-10 conversion tool, ICD-9 to ICD-10 crosswalks, ICD-10 code lookup tool, and many other resources.

The Centers for Medicare & Medicaid Services (CMS) has released an "ICD-10 Next Steps for Providers Assessment & Maintenance Toolkit."

The toolkit is intended to help providers track and improve ICD-10 progress with information and resources.

Areas of focus include:

  • Assessing your ICD-10 progress using key performance indicators (KPIs) to identify potential issues that could affect productivity or cash flow
  • Addressing opportunities for improvement, including troubleshooting issues identified during your assessment and deploying tactics like system enhancements and targeted staff training
  • Maintaining your progress and keeping up to date on ICD-10

ICD-10 KPIs

The toolkit provides a lengthy list of KPIs providers can consider tracking and comparing data before and after the October 1, 2015, ICD-10 effective date. KPIs recommended for consideration include the following:

  • Days to final bill
  • Days to payment
  • Claims acceptance/rejection rates
  • Claims denial rate
  • Coder productivity
  • Daily charges/claims
  • Incomplete or missing charges
  • Incomplete or missing diagnosis codes
  • Medical necessity pass rate

The toolkit also provides a series of helpful tips.

To access the ICD-10 toolkit, click here.

ICD-10 Resources

For additional ICD-10 resources, check out the practice management tools from PGM Billing, a leading provider or practice management solutions. Tools include ICD-9 to ICD-10 crosswalks, ICD-10 code lookup tool, ICD-9 to ICD-10 code conversion tool, and ICD-10 education.

X