September 2012

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One New ICD-9-CM Code Emerges from the Freeze

By Judy Bielby, MBA, RHIA, CPHQ, CCS

New, deleted, and revised ICD-9-CM codes are included every year in the annual update to the Inpatient Prospective Payment System (IPPS). Only one new ICD-9-CM code describing new technology has been added to the code set for this year, effective October 1, 2012: procedure code 00.95 (Injection or infusion of glucarpidase). Glucarpidase (Voraxaze®) is used to treat cancer patients with toxic levels of methotrexate in their blood due to impaired renal function. The new procedure code is listed in Table 6B (New Procedure Codes) of the FY 2013 IPPS final rule. No changes were made to the ICD-9-CM diagnosis codes, effective October 1, 2012. Related to the new procedure code in ICD-9-CM, the 2013 version of the ICD-10-PCS code set contains two new procedure codes: Introduction of Glucarpidase into Peripheral Vein, Percutaneous Approach, 3E033GQ, and Introduction of Glucarpidase into Central Vein, Percutaneous Approach, 3E043GQ.

Only one new code was added and no codes were deleted or revised in the ICD-9-CM diagnosis and procedure code sets due to the partial freeze of ICD-9-CM, ICD-10-CM, and ICD-10-PCS codes prior to the implementation of ICD-10-CM/PCS, a decision made by the ICD-9-CM Coordination and Maintenance Committee. The last regular, annual updates to the ICD-9-CM and ICD-10-CM/PCS code sets occurred on October 1, 2011. There will be only limited code updates to both the ICD-9-CM and ICD-10-CM/PCS code sets, to capture new technologies and diseases as required by section 503(a) of Pub. L. 108-173, until one year after implementation of ICD-10-CM and ICD-10-PCS. After ICD-10 implementation, there will be no further updates to the ICD-9-CM codes.

Health and Human Services has recently issued the final rule that will delay the implementation date for ICD-10-CM/PCS from October 1, 2013, to October 1, 2014. This delay will have an impact on the exact year the code freeze will end. Pat Brooks, RHIA, senior technical advisor for CMS, indicated at the AHIMA 2012 ICD-10 Summit held in Baltimore this April that the partial code freeze for ICD-9-CM will remain throughout any ICD-10-CM/PCS implementation delay. In other words, the first regular update to ICD-10-CM/PCS would be one year after the implementation date—October 1, 2015.

The partial code freeze does not pertain to HCPCS Level I (CPT®) and HCPCS Level II codes. There is also no code freeze for other aspects of the payment systems such as the CC List, MCC List, or HAC List, which are discussed further in the FY 2013 IPPS Final Rule.

References:
Centers for Medicare and Medicaid Services. “2013 Version – What’s New (ICD-10-PCS FY2013 Update Summary).” Available at http://www.cms.gov/Medicare/Coding/ICD10/2013-ICD-10-PCS-GEMs.html

Centers for Medicare and Medicaid Services. “FY 2013 IPPS Final Rule Home Page.” Available at http://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/FY-2013-IPPS-Final-Rule-Home-Page.html

Centers for Medicare and Medicaid Services. “New, Deleted, and Revised ICD-9-CM Codes - Summary Tables.” Available at http://www.cms.gov/Medicare/Coding/ICD9ProviderDiagnosticCodes/summarytables.html

Centers for Medicare and Medicaid Services. "Partial Code Freeze for ICD-9-CM and ICD-10 Finalized." www.cms.gov/ICD9ProviderDiagnosticCodes/Downloads/Partial_Code_Freeze.pdf

Devault, Kathryn. "Data Management a Hot Topic at ICD-10 Summit: Top Ten Lists, Documentation Teams, and Code Freeze Info Among Highlights." Journal of AHIMA 83, no.7 (July 2012): 54-56. http://library.ahima.org/xpedio/groups/secure/documents/ahima/bok1_049660.hcsp

Dimick, Chris. "‘Don't Slow Down’: An ICD-10 Summit Wrap-Up." Journal of AHIMA 83, no.6 (June 2012): 52-58. http://library.ahima.org/xpedio/groups/secure/documents/ahima/bok1_049631.hcsp

“Medicare Prescription Drug, Improvement, and Modernization Act of 2003.” Public Law 108-173. December 8, 2003. Available at http://www.gpo.gov/fdsys/.

Office of the Secretary, Health and Human Services. Administrative Simplification: Adoption of a Standard for a Unique Health Plan Identifier; Addition to the National Provider Identifier Requirements; and a Change to the Compliance Date for ICD-10-CM and ICD-10-PCS Medical Data Code Sets (Proposed Rule). 45 CFR Part 162. Federal Register 77, no. 74 (April 17, 2012) Available at http://www.gpo.gov/fdsys/pkg/FR-2012-04-17/pdf/2012-8718.pdf.

Office of the Secretary, Health and Human Services. Administrative Simplification: Adoption of a Standard for a Unique Health Plan Identifier; Addition to the National Provider Identifier Requirements; and a Change to the Compliance Date for the International Classification of Diseases, 10th Edition (ICD-10-CM and ICD-10-PCS) Medical Data Code Sets (Final Rule). 45 CFR Part 162. Currently on display at http://www.ofr.gov/OFRUpload/OFRData/2012-21238_PI.pdf.


Judy Bielby, MBA, RHIA, CPHQ, CCS, is a clinical assistant professor at the University of Kansas, consultant with Durst & Associates in the Kansas City area, and an AHIMA-approved ICD-10-CM/PCS trainer.


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