Master the upcoming ICD-10 code and IPPS changes! Prepare your team for the upcoming changes taking effect on October 1. Discover the benefits of IPPSPalooza and how it can drive your success. Click here >

Proposed Biannual ICD-10 Implementation Dates: Weighing the Pros & Cons 

Understanding the impact on business processes in the event that biannual ICD-10-CM and PCS updates are implemented is essential – as is your feedback. 

With a comprehensive agenda covered at the virtual ICD-10 Coordination and Maintenance Committee meeting earlier this month, one topic in particular inspired quite a few comments and engagement from attendees.

The Centers for Medicare & Medicaid Services (CMS) and the Centers for Disease Control and Prevention’s National Center for Health Statistics (CDC/NCHS) announced a proposal for introducing an April 1 implementation date for ICD-10-CM diagnosis and ICD-10-PCS procedure code updates.

As presented, “the April 1 code update would be in addition to the existing Oct. 1 update under section 1886(d)(5)(K)(vii) of the Social Security Act for diagnosis or procedure code revisions needed to describe new technologies and medical services for purposes of the new technology add-on payment process.”

If this occurs, the process would require that requestors specify which of the two implementation dates they intend for their proposed changes.

Purportedly, the ICD-10 Coordination and Maintenance Committee would make efforts to accommodate the requested implementation date for each request submitted. However, the Committee would make the determination of which requests would be presented for consideration for April 1 or Oct. 1.

It came as no surprise that the proposal of biannual ICD-10 implementation dates brought about numerous comments during the meeting, with discussions centering on various pros and cons of such an adjustment. First, there are several updates already occurring during the month of April. Add to that new technology features and all that is happening behind the scenes, like with PCS. And though CPT changes become active on Jan. 1, many organizations are still handling changes months later, with delays ranging from system constraints to operational challenges.

On the other hand, this could be a good thing. After all, we have been using the same system with the Oct. 1 date since the inception of ICD-10. Improving efficiencies and enhancing processes is always a positive, even with the expected challenges.

If we learned anything from the COVID-19 pandemic, it’s that we are capable of making swift changes and process improvements. In an extremely limited amount of time, COVID brought about accelerated shifts in healthcare – and all business sectors. Healthcare, in particular, stood up to the test to meet new coding requirements and adjust to processing modifications. Most found that they were able to implement the changes far more quickly than they ever thought possible. The good news is, there is still time to evaluate, and CMS has opened up public comment.

Committee meetings provide a public forum to discuss proposed changes to ICD-10, but no final decisions are made at the meeting. “We are also seeking input on what factors the Committee should consider,” CMS noted, “when determining which requests should be considered for either an April 1 or Oct. 1 implementation date.”

The Committee clarified that the earliest date an April 1 code update option would be considered is April 1, 2022. Comments must be submitted by May 7, 2021, to the CMS mailbox at ICDProcedureCodeRequest@cms.hhs.gov. 

Print Friendly, PDF & Email
Facebook
Twitter
LinkedIn
Email
Print

Susan Gatehouse, RHIT, CCS,CPC, AHIMA-Approved ICD-10-CM/PCS Trainer

Susan Gatehouse is the founder and chief executive officer of Axea Solutions. An industry expert in revenue cycle management, Gatehouse established Axea Solutions in 1998, and currently partners with healthcare organizations across the nation, to craft solutions for unique challenges in the dynamic world of healthcare reimbursement and data management.

Related Stories

New Codes Proposed During Two-Day C&M Meeting

New Codes Proposed During Two-Day C&M Meeting

The Coordination and Maintenance (C&M) Committee meeting was held on Sept. 12 and 13. The meeting began with the procedure proposals, which were followed by

Print Friendly, PDF & Email
Read More

Leave a Reply

Please log in to your account to comment on this article.

Featured Webcasts

Mastering the Two-Midnight Rule: Keys to Navigating Short-Stay Admissions with Confidence

Mastering the Two-Midnight Rule: Keys to Navigating Short-Stay Admissions with Confidence

The CMS Two-Midnight Rule and short-stay audits are here to stay, impacting inpatient and outpatient admissions, ASC procedures, and Medicare Parts C & D. New for 2024, the Two-Midnight Rule applies to Medicare Advantage patients, requiring differentiation between Medicare plans affecting Case Managers, Utilization Review, and operational processes and knowledge of a vital distinction between these patients that influences post-discharge medical reviews and compliance risk. Join Michael G. Calahan for a comprehensive webcast covering federal laws for all admission processes. Gain the knowledge needed to navigate audits effectively and optimize patient access points, personnel, and compliance strategies. Learn Two-Midnight Rule essentials, Medicare Advantage implications, and compliance best practices. Discover operational insights for short-stay admissions, outpatient observation, and the ever-changing Inpatient-Only Listing.

Print Friendly, PDF & Email
September 19, 2023
Secondary Diagnosis Coding: A Deep Dive into Guidelines and Best Practices

Secondary Diagnosis Coding: A Deep Dive into Guidelines and Best Practices

Explore comprehensive guidelines and best practices for secondary diagnosis coding in our illuminating webcast. Delve into the intricacies of accurately assigning secondary diagnosis codes to ensure precise medical documentation. Learn how to navigate complex scenarios and adhere to coding regulations while enhancing coding proficiency. Our expert-led webcast covers essential insights, including documentation requirements, sequencing strategies, and industry updates. Elevate your coding skills and stay current with the latest coding advancements so you can determine the correct DRG assignment to optimize reimbursement, support medical decision-making, and maintain compliance.

Print Friendly, PDF & Email
September 20, 2023
Principal Diagnosis Coding: Mastering Selection and Sequencing

Principal Diagnosis Coding: Mastering Selection and Sequencing

Enhance your inpatient coding precision and revenue with Principal Diagnosis Coding: Mastering Selection and Sequencing. Join our expert-led webcast to conquer the challenges of principal diagnosis selection and sequencing. We’ll decode the intricacies of ICD-10-CM guidelines, equipping you with a clear grasp of the rules and the official UHDDS principal diagnosis definition. Uncover the crucial role of coding conventions, master the sequencing of related conditions, and confidently tackle cases with equally valid principal diagnoses.

Print Friendly, PDF & Email
September 14, 2023
2024 IPPS Summit: Final Rule Update with Expert Insights and Analysis

2024 IPPS Summit: Final Rule Update with Expert Insights and Analysis

Only ICD10monitor delivers what you need: updates on must-know changes associated with the FY24 Inpatient Prospective Payment System (IPPS) Final Rule, including new ICD-10-CM/PCS codes, plus insights, analysis and answers to questions from the country’s most respected subject matter experts.

Print Friendly, PDF & Email
2024 IPPS Summit Day 3: MS-DRG Shifts and NTAPs

2024 IPPS Summit Day 3: MS-DRG Shifts and NTAPs

This third session in our 2024 IPPS Summit will feature a review of FY24 changes to the MS-DRG methodology and new technology add-on payments (NTAPs), presented by senior healthcare consultant Laurie Johnson, with bonus insights and analysis from two acclaimed subject matter experts

Print Friendly, PDF & Email
August 17, 2023

Trending News