Monday, June 18, 2018

Slim Year for ICD-10 Coding Updates

Just like the past couple of years, we've been waiting rather impatiently over the last couple of months for the release of the fiscal year (FY) 2019 ICD-10-CM and ICD-10-PCS code updates.  While the PCS code sets have been out for a month or two, the CM updates were released just last week, sans coding guidelines, which we are still eagerly awaiting.  FY 2019 codes will be implemented on October 1, 2018 (the federal fiscal year runs from October 1 through September 30).  In case you're wondering how the code changes stack up to previous years, what the process is for updating the code sets, or why they aren't released at the same time, this post is for you!

In comparison to past years, it's a slim year for code updates.  When the code sets were unfrozen for FY 2017 after ICD-10 implementation, we saw a whopping 2,710 CM and 4,330 PCS code changes.  Last year, for the FY 2018 release, there were 731 CM and 6,029 PCS code changes.  FY 2019 has a pretty sharp drop for both code sets with 473 CM and 616 PCS code changes. 

If you've been playing along at home and waiting for the code releases, perhaps you've been wondering why the CM and PCS updates are not released at the same time.  Even though both code sets are presented to the Coordination and Maintenance Committee for review and discussion before the Cooperating Parties and general public, each code set is maintained by a separate government agency. 

ICD-10-CM is maintained by the National Center of Health Statistics (NCHS), a component of the Centers for Disease Control and Prevention (CDC).  ICD-10-PCS is maintained by the Centers for Medicare and Medicaid Services (CMS).  Twice a year (every March and April), both agencies present proposed code changes at the Coordination and Maintenance meetings in Baltimore and then each agency works to finalize the code sets. 

Over the past couple of years, we've noticed that PCS changes happen more quickly and are released earlier than their CM counterparts.  CMS presented code proposals for FY 2019 as late as the March 2018 meeting.  On the other hand, most of the code proposals that NCHS presented for CM in March were for consideration for FY 2020.

The other trend we've been noticing since converting to ICD-10 is the last thing to be released is generally the ICD-10-CM Official Guidelines for Coding and Reporting.  We are still waiting for the FY 2019 coding guidelines to be released.  It's been common for NCHS to release the code sets first and the guidelines at a different time, whereas CMS has been pretty consistent with releasing the PCS code sets along with the ICD-10-PCS Official Guidelines for Coding and Reporting.

If you read this post hoping I would give some spoiler alerts, you'll have to wait for the webinars I'm presenting in August for Haugen Consulting Group.  I hope you'll click the links to the marketplace and register for one or both (CM and PCS) updates webinars where I will outline the changes with some background information and a healthy dose of Haugen fun.  Well, fun is relative - we're still talking about coding, but who said that has to be boring!

Here are the links to help keep you updated for FY 2019!