Anesthesia Coding Alert

Say good-bye to the code freeze – especially for cardiology claims.

The five-year freeze coders and providers have enjoyed with the ICD-10 system is about to end: Oct. 1, 2016, will bring the first set of the manual’s annual updates. The changes will be significant, according to information CMS released for public review. If accepted, alterations will include:

• 1,943 new codes, 422 revisions, and 305 deletions for ICD-10-CM
• 3,651 new codes, 351 revisions, and 313 deletions for ICD-10-PCS.

Plus: The ICD-10 Coordination and Maintenance Committee reviewed proposals for updating ICD-10-CM and PCS. If approved, these would be included in the Oct. 1, 2017, classification system addenda for FY 2018.

Updates allow new or revised codes to encompass recent advances and trends in healthcare. The new codes have arrived sooner than many experts expected.

Sneak peek: The majority of the new codes fall under the cardiovascular system. These relate to:

• Unique device values
• Addition of bifurcation as a qualifier
• Additional specific body parts
• Congenital cardiac procedures
• Placement of intravascular neurostimulators.

What it means: As an anesthesia coder, once these updated diagnoses are effective, it will be even more important for you (or your provider) to communicate with the surgeon so you can assign the most accurate diagnosis.

The committee reviewed 24 diagnosis proposals, such as:

• Congenital sacral dimple: The American Academy of Pediatrics proposed a new congenital code so this condition can be accurately tracked.
• Myocardial infarction: Specify the types as defined by several professional cardiology organizations. A specific code was proposed for type 2 myocardial infarction due to demand ischemia or ischemic imbalance so that data can be captured. The additional myocardial infarction types (3, 4a, 4b, 4c, 5) would all be assigned to one ICD-10-CM code. There was much discussion on this proposal related to the code proposals as well as the indexing and impact on subsequent myocardial infarctions. This proposal was requested for inclusion in the 10/1/16 addenda.
• Zika virus was discussed, regarding a new code being created. NCHS/CDC is proposing it for inclusion in the 10/1/16 addenda which would be consistent with the World Health Organization (WHO).

Learn more: The final addenda with additions/ revisions will be published in June at www.cms.hhs.gov. You can find the ICD-10-CM addendum at www.cdc.gov/nchs/icd/icd10cm.htm. 

Start preparing: “While physicians, practitioners, and coding staff are all still acclimating to ICD-10 coding, we must use the next several months to refine the coding process through ongoing training efforts,” advises Duane C. Abbey, PhD, president of Abbey and Abbey Consultants Inc., in Ames, Iowa. “Particularly in the cardiology area, many, if not most, hospitals provide various levels of service that will be affected by these changes.”