The Coordination and Maintenance Committee Meeting was held March 7-8 at the Centers for Medicare & Medicaid Services (CMS) headquarters for the purposes of reviewing proposals for new ICD-10-CM (diagnosis) and ICD-10-PCS (procedures) codes for the 2018 and 2019 fiscal years.
Comments on the proposals for 2018 are due April 7, 2017. This article provides more detail on two subjects – types of myocardial infarctions (MI) and heart failure classifications.
The types of myocardial infarctions are based on the American College of Cardiology (ACC) categorization.
In the code proposals, type 1 would be included in I21.0-I21.4, which are the ST elevation myocardial infarctions (STEMI) with the specificity of the involved wall and non-ST elevation myocardial infarction (NSTEMI). A new code would be added for MI NOS (I21.9). Type 2 would be assigned a new code of I21.A1. MI types 3-5 would be assigned to the proposed new code of I21.A9. Please note that demand ischemia will remain at I24.8 unless specified as “with myocardial infarction.” If that documentation is provided, the new code of I21.A1 would be assigned, as it is now a type 2 MI.
The proposal for heart failure classifications is based on those used by the ACC as well as the American Heart Association. The entities use stages of A, B, C, and D. The New York Hospital Association classifications have not been included in this proposal.
The heart failure stages are defined as:
A new subcategory is proposed for right heart failure (I50.84). New codes have been proposed for biventricular failure (I50.82), high-output heart failure (I50.83), end-stage heart failure (I50.84), and other heart failure (I50.89). These new codes will provide more information regarding the patient’s severity of illness.
Comments regarding the proposed diagnosis and procedure codes are due on April 7 for the codes for which expedited action has been requested. Comments regarding ICD-10-CM can be emailed to the Centers for Disease Control and Prevention (CDC) at nchsicd10CM@cdc.gov. The comments for ICD-10-PCS can be emailed to CMS at ICDProcedureCodeRequest@cms.hhs.gov. Here is your opportunity to participate in the code development process! I look forward to seeing the results in June 2017.
Here’s the uncomfortable truth: many hospitals and state Medicaid plans, under pressure from HR1 data analysis needs, are paying eye-watering markups to for-profit CPA and
As discussed last week, payments to Medicare Advantage (MA) plans are adjusted to account for expected healthcare resource consumption by enrollees. Higher risk scores increase
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