March 14, 2016

A Further Update to Zika Virus Coding

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The Centers for Medicare & Medicaid Services (CMS) Coordination and Maintenance Committee meeting continued on March 10, with additional diagnosis code applications being discussed.

I am always impressed with the depth of clinical knowledge presented at this meeting, in conjunction with debates regarding suggested coding changes. During these sessions, attendees learned the “spirit” of requested changes. 

A total of 25 topics were presented at this meeting, with the majority scheduled for potential inclusion for the update of the 2018 fiscal year (due to be released Oct. 1, 2017). During the presentations last week, there were great debates between clinical and coding experts. True coders are passionate about their classification set!

Also during the meeting, Donna Pickett with the Centers for Disease Control and Prevention (CDC) discussed an update to the Zika virus. The industry has been waiting for the CDC to publish coding guidance regarding this topic. The current guidance is that confirmed cases should be assigned A92.8 (Zika virus).    

Pickett advised the audience that, according to the experts at CDC, the science has not been confirmed regarding the relationship between Zika and congenital deformities such as microcephaly. For that reason, an ICD-10-CM code will not be created until the relationship can be scientifically confirmed.

The World Health Organization (WHO) is also in the process of creating a new code for the Zika virus for ICD-10. It has assigned a temporary code from the U chapter, which is not part of ICD-10-CM at the current time. WHO also has been working through its update process to assign a permanent code for ICD-10, and it has decided on A92.5. Pickett noted that A92.5 may be part of the addenda for Oct. 1, 2016, and WHO approval for an early adoption of this code has been confirmed.

It is easy to be part of the adoption cycle for ICD-10-CM codes (and ICD-10-PCS). Review the addenda, which can be found online at http://www.cdc.gov/nchs/icd/icd9cm_maintenance.htm. Comments regarding these proposals for ICD-10-CM codes to be implemented by Oct. 1, 2016 are due April 8, 2016, and they can be sent to . If you wish to make comments on ICD-10-CM codes to be implemented on Oct. 1, 2017, the comments are due by May 6, 2016.Of course, the sooner comments are submitted, the easier it would be for the CDC.

The final decisions regarding the proposed diagnosis and procedure codes are being made with consideration of the public’s comments.

CMS administrates the procedure codes and the CDC manages the diagnosis codes. It is up to the coding community to voice its opinions regarding the proposals. If you have been commenting to your co-workers or supervisors about the ICD-10-CM/PCS code set, here is your opportunity to make an impact.   

Review the video of the presentations after it becomes available later this month, and provide comments. The final version of the diagnosis and procedure addenda is scheduled to be released in June 2016.    

Laurie Johnson, MS, RHIA, CPC-H, FAHIMA, AHIMA-Approved ICD-10-CM/PCS Trainer

Laurie M. Johnson, MS, RHIA, FAHIMA is currently a senior healthcare consultant for Revenue Cycle Solutions, based in Pittsburgh, Pa. Laurie is an American Health Information Management Association (AHIMA) approved ICD-10-CM/PCS trainer. She has more than 35 years of experience in health information management and specializes in coding and related functions. She has been a featured speaker in over 40 conferences. Laurie is a member of the ICD10monitor editorial board and makes frequent appearances on Talk Ten Tuesdays.

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