Providing Details on Code Development

Last week during Talk Ten Tuesdays, there were several questions about the Coordination and Maintenance Committee, as well as the CPT® Editorial Panel meetings. As such, let us today delve into the code development process.

The Coordination and Maintenance Committee is a federal committee comprised of representatives from the Centers for Medicare & Medicaid Services (CMS) and Centers for Disease Control and Prevention (CDC). The committee holds public meetings twice a year – usually in March and September. New ICD-10-CM/PCS codes become effective April 1 or Oct. 1. The committee is responsible for approving new or revised codes, as well as for developing errata, addenda, or other modifications. ICD-10-CM, which is administered by the CDC, is based on the World Health Organization’s (WHO’s) ICD-10. ICD-10-PCS is administered by CMS and is utilized to report inpatient procedures in the United States.

The Coordination and Maintenance Committee meetings are public virtual forums to discuss code proposals. Attendees may ask questions of the presenters and suggest changes to each code proposal. CMS presents the procedure code proposals on the first day, and the CDC coordinates the diagnosis proposals immediately following. The meetings take place over two days. Anyone can submit a request to add or revise an ICD-10-CM/PCS code.

The Coordination and Maintenance Committee website can be found on the CMS ICD-10 website. Select ICD-10 Coordination and Maintenance Committee meetings are listed on the lefthand menu. This site provides a link to the meeting materials for the procedure portions of the meetings. There is also a link to register for the meetings. You must register to attend. The diagnosis portion of the meeting information can be found at the bottom of the page under “Related Links.” This section includes a link to the CDC ICD-10-CM Coordination and Maintenance Committee meetings. This link will lead you to the ICD-10-CM Coordination and Maintenance Committee website. This site displays the dates for upcoming meetings and agendas as well as topic packets, presentation materials, and recordings of previous meetings. The next meeting will be held March 19 and 20.

The American Medical Association (AMA) manages Current Procedural Terminology® (CPT) through the CPT Editorial Panel. This group is authorized to maintain the integrity of CPT, which is the code set used to report services and procedures by physicians. CPT codes are also used by hospitals to report outpatient procedures and services.

This panel is scheduled to meet May 9 through 11 and Sept. 19 through 21 this year. The deadline for applications is Feb. 5 and June 12, respectively, for the meetings. The purpose of the meetings is to seek input from practicing physicians, medical device manufacturers, diagnostic test developers, and advisors from various medical societies. The public can attend and listen to the discussion in person or virtually. These sessions are not recorded, but a summary of the panel’s actions is posted on the website approximately 30 days after each meeting.

These two types of meetings are wonderful resources to learn about the clinical aspects of a code, but also the “spirit” of the code. The attendee learns what prompted the code to be requested, and the background of that need.

Resources:

CPT Editorial Panel Meetings and Registration:
https://www.ama-assn.org/about/events/cpt-editorial-panel-meeting

CPT Editorial Panel:
https://www.ama-assn.org/topics/cpt-editorial-panel

ICD-10-PCS Coordination and Maintenance Committee Meeting Information: https://www.cms.gov/medicare/coding-billing/icd-10-codes/icd-10-coordination-maintenance-committee-meetings

ICD-10-CM Coordination and Maintenance Committee Meeting Information:
https://www.cdc.gov/nchs/icd/icd10cm_maintenance.htm