New ICD-10 Codes on the Way

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Rhonda Oakes By Rhonda Oakes 
Regulatory Analyst, Change Healthcare
New ICD-10 Codes Coming Soon

If you thought your coders could breathe a sigh of relief after transitioning to ICD-10 and its 68,000 codes in October, you may need to think again.

In March the Centers for Medicare & Medicaid Services (CMS) and the Centers for Disease Control and Prevention (CDC) released 3,651 procedure coding system (PCS) codes and 1,943 clinical modification (CM) codes. Both sets of  code changes will take place on October 1, 2016, giving software companies time to reconfigure clinical and billing systems to roll out changes and home care organizations some flexibility to adapt to the changes.

Adding, modifying and deleting a large number of codes may seem odd, but changes to the ICD-10 code set were frozen five years ago as the changeover from ICD-9 moved closer. So consider these remnants of the initial changeover. I wouldn’t expect future code revisions to be anywhere near the volume of changes that are occurring for the next fiscal year.

Both the American Hospital Association and the American Health Information Management Association praised the federal agencies for releasing the new codes early enough that they could react.

During the first 4.5 months using the new ICD-10 codes, the denial rate among RelayHealth Financial’s revenue cycle management solutions customers was just 1.6%. The good news is that the denial rate has remained about the same since November, which is a testament to how well the overall changeover went.

However, if you’re among the organizations that are having their claims denied, there’s no doubt you see things differently. Those denied claims represent nearly $13 billion and only reflect the denial categories of Authorization/Pre-Certification, Medical Coding, Medical Necessity and Untimely Filing.

The World Health Organization, which oversees the International Classification of Diseases (ICD), has scheduled the release of ICD-11 for 2018. The United States isn’t expected to adopt ICD-11 until several years later.

You already know that in healthcare, the only constant is change. Amid the care and reimbursement pilots and mandates your organization also is facing, ICD changes are a minor blip. Important, of course, but minor in the grand scheme of things.

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