CMS Updates ICD-10 Quality Measures, More from C&M Meeting

Original story posted on: April 17, 2017
The Centers for Medicare and Medicaid Services (CMS) has released an update to the ICD-10 and Quality Measures website. The home page covers ambulatory surgical centers, hospital inpatient and outpatient, Centers for Disease Control (CDC) and National Healthcare Safety Network (NHSN) Surgical Site Infections (SSI) Measures, CMS outcome and payment measures, Agency for Healthcare and Quality (AHRQ) Patient Safety Indicator (PSI) 90, Physician Quality Reporting System (PQRS), and Home Health.  There is also a Frequently Asked Questions (FAQ) document on the home page.

In other healthcare news, the Coordination and Maintenance Committee Meeting was held March 7 and 8 at the CMS headquarters in Baltimore, Md, for the purposes of reviewing proposals for new ICD-10-CM (diagnosis) and ICD-10-PCS (procedures) for fiscal years (FY) 2018 and 2019.  This article covers two topics: of cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephaly (CADASIL) and lacunar infarcts.

CADASIL is an autosomal dominant genetic disorder caused by mutations in the Notch3 gene.   The condition causes thickening of walls of small arteries with loss of blood supply and impacts the white matter and deeper tissues of the brain. The most frequent symptoms are migraine headaches and mood disorders in patients in their twenties and thirties with strokes for patients in their forties and fifties. The multiple strokes lead to vascular dementia.    Death usually occurs within 10–20 years of the stroke and dementia onset.

A new subcategory has been proposed in ICD-10-CM of I67.85, which is described as hereditary cerebrovascular diseases. The proposed CADASIL code is I67.850. Instructions indicate that any associated diagnoses, such as stroke, epilepsy, and vascular dementia. A code has been established in the beta version of ICD-11 so there is a need to maintain consistency between the two code sets.

Lacunar infarctions are cerebral infarcts of small penetrating branch vessels deeper in the brain.   These infarctions have a favorable prognosis. The American Academy of Neurology has requested a distinct code that is specific to lacunar infarction.    This code proposal was initially discussed at the March 2016 Coordination and Maintenance Committee meeting, but the World Health Organization (WHO) was also discussing the addition of this concept. In October 2016, WHO approved the classification to I63.8. In March 2017 at Coordination & Maintenance Committee meeting, the lacunar infarct proposal with a new code for lacunar infarct of I63.81 and a separate code of I63.89 (another cerebral infarction) was discussed. There were no voiced objections.

Comments regarding the proposed diagnosis and procedure codes were due on April 7 with a request for expedited action. We look forward to seeing the results of the code discussions in June 2017.  For a sneak peak, review the Inpatient Prospective Payment System Proposed Rule for FY18, which is due any day.
Disclaimer: Every reasonable effort was made to ensure the accuracy of this information at the time it was published. However, due to the nature of industry changes over time we cannot guarantee its validity after the year it was published.
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.

Related Stories

  • National Coding Contest Raises Serious Industry Questions
    Contest indicates coding accuracy is below expectations. Central Learning is a web-based coding assessment and education application. Since 2016, the company has conducted an annual national coding contest to measure ICD-10 coding accuracy and production. The initial premise was to…
  • UPMC versus Highmark – Can UPMC Pop Champagne Corks?
    The saga continues between UPMC hospitals and Highmark. UPMC reported revenue of $5.1 billion in the quarter ending March 31, 2019, up 10 percent from the $4.6 billion reported in the first quarter of last year. At the same time,…
  • CMS Proposed Rules Will Impact SNFs and Hospice Providers
    Proposed rules also include new payment models. The Centers for Medicare & Medicaid Services (CMS) has been quite busy these last few weeks issuing the proposed payment rules for 2020 and making some other announcements.  Here is an update on…