The Freeze Is Over Check Out New ICD-10

Codes for October 1!

By Susan Dooley

Get ready ICD-10 adds more than 5,500 new codes this October 1! Thats 1,943 new ICD-10-CM codes
(available here) and 3,651 new ICD-10-PCS codes (available here), going into effect for fiscal year 2017,
which runs Oct. 1, 2016, through Sept. 30, 2017. The new codes take effect just in time for ICD-10s first
anniversary, effectively ending the five-year code update freeze intended to help the healthcare
industry transition to the new code set. Bottom line: Now that weve successfully met the diagnosis
code conversion challenge, its time to update ICD-10 maybe even with a new code specifically for
Zika virus.

The Coding Institute LLC, 2222 Sedwick Road, Durham, NC 27713, Eenterprise Contact: Sam Nair, Direct: 704 303 8150,
shyamn@codinginstitute.com

Meet the ICD-10 Coordination & Maintenance Committee

The ICD-10 C&M Committee is co-chaired by CMS and the CDC, with CMS taking the lead on ICD-10-PCS
(procedure) issues and CDC leading the ICD-10-CM (diagnosis) issues. The March 9 and 10, 2016, C&M
Committee sessions are available in full on You Tube thats some eight-plus hours of videos covering
the proposed procedure and diagnosis coding changes. The final code changes will be published in June.

AHIMA Submits Comments on Changes

During the public comment period, which ended in April, the American Health Information Management
Association (AHIMA) submitted comments on some of the changes proposed to take effect in October
2016. AHIMAs officials noted that the changes to ICD-10-PCS were largely covering cardiovascular
devices and procedures. The ICD-10-CM changes, though less numerous, were much broader in scope.
Why new ICD-10 codes, you ask? Just think how many changes medicine has seen since 2011 for
example, back then hardly anyone in the U.S. even knew what Zika virus was. The new codes reflect
these advances and allow coders to capture diagnoses and care in a much more granular way, according
to Angie Comfort, RHIA, CDIP, CCS, a director of HIM practice excellence at AHIMA.

Sneak Peak at PCS Changes

The new ICD-10-PCS codes deal with new procedures including adding bifurcation as a qualifier, adding
congenital cardiac procedures, and creating new codes for placement of intravascular stimulators. In
some cases AHIMA expressed its support for the new codes, and in others, it recommended against
adding them. Heres a sampling of some of the PCS codes to which AHIMA requested changes, revisions,
or deletions:

SPY Fluorescence Vascular Angiography (FVA)

Oxidized Zirconium on Polyethylene Bearing Surfaces for Hip and Knee Arthroplasty
Spinal Fusion with Nano-Textured Surface
Insertion of Endobronchial Coils
Hematopoietic Cell Transplant Donor Type
Minimally Invasive Aortic Valve Replacement
Total Anomalous Pulmonary Venous Return (TAPVR).

First Look at Diagnosis (CM) Changes

The C&M Committee also reviewed 24 diagnosis code proposals, including the following, which are
potential additions to the 1,943 new ICD-10-CM codes discussed above:

Congenital sacral dimple: These minor congenital anomalies, which are small depressions in the
skin located just above the buttocks, occur in up to 4 percent of children. The American
Academy of Pediatrics asked for this new code to track the conditions occurrence, as it may or
may not be related to spina bifida occulta.
The Coding Institute LLC, 2222 Sedwick Road, Durham, NC 27713, Eenterprise Contact: Sam Nair, Direct: 704 303 8150,
shyamn@codinginstitute.com

Classification of myocardial infarction: Several professional cardiology organizations proposed

changes to MI diagnosis coding, including a specific code for type 2 MI due to demand ischemia
or ischemic imbalance. AHIMA noted that this was a complex topic and recommended it be
brought back to the September C&M meeting for further discussion.
Zika virus: NCHS and CDC proposed that a new Zika code be included in the Oct. 1, 2016,
addenda, to be consistent with the World Health Organizations (WHO) proposal. AHIMA said
that it fully supported not only a unique code for Zika, but also additional Zika-related codes,
such as exposure to Zika and history of Zika infection, since the proposed new code would only
capture patients with current, active Zika infections. WHOs proposed new code would be A92.5
(Zika virus disease), fitting into the group A92 (Other mosquito-borne viral fevers). Another
emerging mosquito-borne febrile illness, Chikungunya virus, is also a member of that group, at
A92.0 (Chikungunya virus disease).

What Do You Think?

I live in Florida, where some say our state bird should be a mosquito. Our healthcare community is
understandably worried about Zikas spread. I think implementing a specific Zika code as soon as
possible is a great idea. What about you? Write to us.

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Contact Us:
Name: Sam Nair
Title: Associate Director
Email: shyamn@codinginstitute.com
Direct: 704 303 8150

Desk: 866 228 9252, Ext: 4813

The Coding Institute LLC, 2222 Sedwick Road, Durham, NC 27713

The Coding Institute LLC, 2222 Sedwick Road, Durham, NC 27713, Eenterprise Contact: Sam Nair, Direct: 704 303 8150,
shyamn@codinginstitute.com