April 24, 2018

Anxiety Builds Over Release of 2019 ICD-10-CM/PCS

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Anticipated schedule of the posting of new ICD-10 codes, including dates for public comment.

Typically, after the annual Coordination and Maintenance Committee meeting, the next question is this: when will the new codes be published? The short answer is potentially near late April or early May. Final decisions regarding the ICD-10-CM/PCS classification systems are not made at these meetings.  

The comment period recently passed for providing feedback on the ICD-10-PCS codes that were presented on March 6, 2018. The Centers for Medicare & Medicaid Services (CMS) listened to the comments during this public meeting and will review the received written comments before making any final decisions for the new inpatient procedure codes for the 2019 fiscal year, which begins Oct. 1, 2018.

The public written comments on the March 2018 ICD-10-CM proposals are not due until May 11, 2018. Comments on the March 2018 proposals may be submitted to . The Centers for Disease Control and Prevention (CDC) will review the public verbal comments as well as the written comments before making their final decision for the 2020 fiscal year, which begins Oct. 1, 2019. The webcast can be viewed online at https://www.cms.gov/Medicare/Coding/ICD9ProviderDiagnosticCodes/meetings.html.

The first glimpse of possible new codes may be published later this month (or perhaps early May), as noted earlier, with the release of proposed rule for the Inpatient Prospective Payment System (IPPS). Additional comments may be made on this proposed rule. The final addendum for ICD-10-CM/PCS is published in June. Those final files are publicly available on the CMS and CDC websites.  

Prior to ICD-10 implementation, the final codes were released in August, with the IPPS final rule. A change was made with ICD-10 to accommodate the software vendors so they would have time to update the software for Oct. 1. The final rule can be found online at http://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/index.html?redirect=/AcuteInpatientPPS/IPPS/list.asp.

The ICD-10-CM update is a longer process than that of ICD-10-PCS. The CDC must coordinate its updates with the changes that the World Health Organization (WHO) is making to ICD-10, which is the base for all versions of ICD-10. ICD-10-PCS originates in the United States, so CMS controls its development. The procedure requests can be assimilated much faster.

The IPPS proposed rule will also include potential new technology add-on payments (NTAP) for MS-DRGs. NTAP is usually captured through ICD-10-PCS codes. This proposed rule can be accessed online at http://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/index.html?redirect=/AcuteInpatientPPS/IPPS/list.asp.

Requests for a new code or code revision must be submitted prior to July 13. The agenda for the September 11-12 Coordination and Maintenance Committee meeting will be published in August 2018. This agenda will provide coders a chance to peek at more potential new codes for diagnoses and procedures. The diagnosis agenda will be found online at http://www.cdc.gov/nchs/icd/icd10cm_maintenance.htm. The procedure agenda can be found at https://www.cms.gov/Medicare/Coding/ICD9ProviderDiagnosticCodes/ICD-9-CM-C-and-M-Meeting-Materials.html

If you are planning to attend in person, completion of an online registration form is required. Registration for the Coordination and Maintenance Committee meeting will be available from Aug. 3 through Sept. 3, 2018. Information regarding registering online can be found at http://www.cms.hhs.gov/apps/events/.

The URL to see the FY19 ICD-10-CM codes when they have been published in June will be  http://www.cdc.gov/nchs/icd/icd10cm.htm. The URL for the FY19 ICD-10-PCS codes when they are published will be http://www.cms.gov/Medicare/Coding/ICD10/index.html.  

Education on the new codes should be completed prior to Oct. 1, 2018. The coders should be aware of NTAP as well as what the documentation supports the new codes. The classifications continue to expand.


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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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