March 14, 2016

The Future of ICD-10-CM/PCS Coding Changes

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Following the Centers for Medicare & Medicaid Services (CMS) ICD-10-CM/PCS Coordination and Maintenance Committee meeting and public comments and discussion occurring on March 9 and 10, there is lots to follow and stay tuned about in the coding world. This is due to the code freeze being scheduled to end on Oct. 1, 2016, after which we will see a generous volume of new codes for both diagnosis and inpatient procedure coding.

The final outcome and approval of all ICD-10-CM/PCS code changes has not taken place just yet, but the discussion following this recent meeting focused on 3,651 new procedure codes (ICD-10-PCS) and 487 code revisions and 1,928 new diagnosis codes (ICD-10-CM) for the 2017 fiscal year. It was learned that the majority of changes will be implemented in October 2017. Final outcome from the public dialogue will come later from CMS.

Let’s begin with thinking through the depth of the changes and plan accordingly, as planning will be key to the successful adoption of the new codes. Waiting until the last minute (i.e. September), as we all know, is neither a good practice nor a smart thing to do. So promote and provide the coding education and training that is needed. Keep in mind that this is very similar to large volumes of CPT® code changes; we need to prepare and ensure that coding staff understand the changes and know how to apply the correct code(s). We then will need reviews of the coding, assessments, or audits in place immediately, after October, to validate coding accuracy and quality, not to mention documentation training and bringing in our clinical documentation improvement (CDI) staff as well.

If your facility, practice, or organization provides internal coding education and training, there will need to be time set aside to prepare the curriculum material and for the presentation itself to coding staff and others. If you utilize external resources for your coding educational services and resources planning, communicating early rather than later is again the best step to take. You’ll want to discuss the specific content, time available (this may have a budgetary impact), and how best to present the material, i.e. via webex or email or in person in the classroom setting.

Be sure to dialogue with your coding vendor/supplier about the code changes and the updates that will occur with their software. Ask when this is scheduled to occur, how it will occur, and how long it will take. Also check with your internal systems staff that will help ensure that the update is installed on time and correctly.

Another important step to take in planning for the 2017 code changes is to follow your professional organizations and visit their websites for information and opportunities to learn more about general coding changes, but also coding specifics via coding webinars, seminars, and other educational programs. Remember to work together within your organization and not remain in silos. If your organization has divisions or regions, the education and training should be centralized and uniform for consistency and continuity. Don’t forget to talk with revenue cycle and compliance leadership as well about the planned education and key code changes that may have an impact to revenue and/or present compliance risk.

It’s important for coding health information management (HIM) professionals in particular to respond to the suggested changes in the code set, as this is the time for public input. First, review the minutes and videos from the two-day C&M meeting. You then can provide feedback by sending comments on the procedure (PCS) code changes; these should go to CMS by April 8, 2016 at . Comments on the diagnosis (CM) code changes should go to by May 6, 2016.

Watch for the final rule, including the Inpatient Prospective Payment System (IPPS) changes to come out this summer, early in August 2016.

Remember to stay tuned and connected!

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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