Communication, collaboration, and coding exemplify the tone of last week’s C & M meeting.

“Communication, collaboration, and coding” are three words that describe the March 6 and 7 ICD-10 Coordination and Maintenance meetings in Baltimore last Tuesday and Wednesday. The meetings were conducted at the headquarters of the Centers for Medicare & Medicaid Services (CMS) in Baltimore.

With 16 requested PCS codes and 25 requested CM codes, the requested list is smaller than in the previous few years.

The meetings began with a review of PCS codes. There was active discussion between physicians and coding experts regarding most of the requests. The physicians want to be able to obtain data about the procedures being performed for either Food and Drug Administration (FDA) approval or improved quality of care for patients. The exchange between the two groups was productive and collaborative; the physicians all expressed how grateful they are for the coders in their organizations, and the coder experts in attendance reciprocated.

The conversations many times focused on how new procedures or diagnoses will be documented in the record, along with concern about the consistency of this documentation across the country. The proposed PCS codes with the most discussion included irreversible electroporation, endovascular intracranial thrombectomy, insertion of the Remede® System stimulation led into the left pericariophrenic vein, and percutaneous extracorporeal membrane oxygenation (EXMO).

There continues to be concern about PCS section X, New Technology. The Centers for Medicare & Medicaid Services (CMS) team reminded everyone that this section was added specifically for new technology, and that we PCS coders will be added and deleted from this section. There was surprise that CMS was not maintaining this section themselves, and that they wanted recommendations to delete or move section X codes to another section. CMS reminded the attendees that this is a collaborative process, and they want recommendations when codes should be deleted or moved.

The review of new CM topics started on Tuesday afternoon and continued all day on Wednesday. A number of the new CM codes are associated with pediatrics. One the presenters commented that we are on the brink of identifying many new diseases, with advances being made in genetics. This change will have an impact on CM coding in the future.

A couple of new CM codes that had a bit more discussion than others were those for left against medical advice and travel counseling. Many in the audience were not aware of a CM code for left against medical advice since this a standard disposition code and not a diagnosis. Travel counseling is proposed to be used for visits when the patient wants to know about traveling to various countries.

Each coder and organization will want to review the notes from the meeting and comment to help ensure that our coding system serves the goal of achieving the ability to accurately code CM/ PCS and improve data collection and aggregation.

Register to listen to Talk Ten Tuesdays today at 10 a.m. for two reports on the recent C & M meeting.

Recordings are available online here:

PDF of proposed changes are attached:

pdfTopic Packet March 2018

pdfPCS March 6 Agenda

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Laurie A. McBrierty, MLT ASCP, CICA

Laurie McBrierty brings nearly 30 years of experience in healthcare, healthcare information systems, and product management to Career Step, where she drives the product management of the company’s offerings. Prior to joining Career Step, Laurie served in various executive positions with companies such as xG Health Solutions, WellPoint, Resolution Health, QuadraMed, Kaiser Permanente, SoftMed, 3M HIS, and Stanford Health Services. She has also served on various boards and committees within the American Health Information Management Association (AHIMA) and is a respected leader in health information management. Laurie holds a bachelor’s degree in Information Systems Management from the University of San Francisco.

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