July 11, 2016

Many New ICD-10-PCS Codes – Preparation and Follow-through is Key

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With the release of the new ICD-10-PCS codes for the 2017 fiscal year effective October 2016, we certainly are hearing lots of discussion and opinions. There are 3,827 new hospital inpatient procedure codes, and 97 percent will update the cardiovascular and lower joint body systems, per the Centers for Medicare & Medicaid Services (CMS). Here is the summary and change between 2016 and 2017:

2016 Total Codes

New Codes

Revised Titles

Deleted Codes 

2017 Total Codes

71,974

3,827

491

12

75,789

Just like with the full implementation of ICD-10 here in the United States last October, we need to prepare for this change as well. One of the first steps to attend to is to review the CMS 2017 ICD-10 PCS files online at https://www.cms.gov/Medicare/Coding/ICD10/2017-ICD-10-PCS-and-GEMs.html

The 2017 ICD-10 Procedure Coding System (ICD-10-PCS) files at the CMS website contain information on the ICD-10-PCS updates for the 2017 fiscal year. These 2017 ICD-10-PCS codes are to be used for discharges occurring from Oct. 1, 2016 through Sept. 30, 2017.

The following is a list of the ICD-10-PCS files posted by CMS:

The general equivalence mappings (GEMs) will be posted on the website in August, according to CMS.

The next step is to start to develop educational material for your coding staff, coding auditors, and coding educators. Summarize the changes and include case scenarios for the education recipients so they can practice coding with the new ICD-10-PCS codes. Include some information about anatomy and physiology also to help enhance coding competencies, especially with most code changes being in the cardiovascular and lower joint body systems.

Also include a post-educational assessment or quiz to validate that the educational material was understood. A best practice is to prepare a knowledge assessment or quiz with 20 questions, often multiple choice in format. Another important aspect to offering coding education and training is to provide continuing education units, or CEUs. Check the American Health Information Management Association (AHIMA) and/or AAPC websites regarding the CEU process and requirements. Plan ahead for this so you are prepared when conducting the education in September.

Another step to take is to identify and understand the impact the ICD-10-PCS codes will have on MS-DRGs. The new and revised ICD-10-CM (Clinical Modification) and ICD-10-PCS (Procedure Coding System) codes will be included in the hospital Inpatient Prospective Payment System (IPPS) final rule for the 2017 fiscal year, which is expected to be released in early August. Some education on the MS-DRG changes will also need to be developed and provided to your hospital coding staff in particular.

Once the new codes are implemented, then a follow-through step to take in your preparations is to conduct coding audits or quality validation assessments to ensure that the coding is accurate.

Remember that if you don’t develop your own coding education, check out the many resources that are available, such as those offered by the California Health Information Association (CHIA) and AHIMA. There are also many coding educational programs offered through vendors across the healthcare industry.

Planning and conducting the necessary follow-through with coding education and training is key, and the time to start is now.
Gloryanne Bryant, RHIA, CDIP, CCS, CCDS, AHIMA-Approved ICD-10-CM/PCS Trainer

Gloryanne is a coding and HIM professional with 35 years of experience. She is the past president of the California Health Information Association. Gloryanne is a member of the ICD10monitor editor board and is a popular guest on Talk Ten Tuesdays.

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