Just when we thought we had a handle on ICD-10-CM, CMS has announced the first changes to the code set. They can be found at: https://www.cms.gov/Medicare/Coding/ICD10/2017-ICD-10-CM-and-GEMs.html. In order to familiarize yourself with the changes that will be most important to your practice, take a look at the pertinent categories in the file titled, 2017 Addendum. There you will find additions, deletions and revisions for each section of the code set from the Index to the Tabular, including the Neoplasm Table, the Table of Drugs and Chemicals, and the Index to External Causes.
Start with the sections that you use most often and be sure to share the information with your providers. There may be additional or different instructional notes that they will need to know in order to code correctly (both accurately and completely). For instance, in diabetes categories E08, E09, E11 and E13, we are told to “Use additional code to identify control using: insulin (Z79.4), oral antidiabetic drugs (Z79.84), oral hypoglycemic drugs (Z79.84).” For hypertension, we now have codes for hypertensive crisis, category I16, differentiated by urgency or emergency. And some Excludes1 notes have become Excludes2 notes as in heart failure. We can now report the cardiac arrest and the fluid overload in addition to heart failure.
These are just a few examples of the changes to the code set. It is also important at this stage of transition, to assess your progress. CMS has posted an assessment tool that will help you identify any room for improvement in their Next Steps Toolkit found at: https://www.cms.gov/Medicare/Coding/ICD10/Latest_News.html which includes an interactive tool and a fact sheet.
As I always say, the only constant is change. In order for us to succeed in medical coding, we must be aware of and be ready to adapt to the changes. And remember, these changes become effective October 1, 2016, just 3 months from now.
