Tuesday, May 27, 2014

CMS Provides Updates on ICD-9 and ICD-10

Dianne De La Mare

Last week, the Centers for Medicare and Medicaid Services provided updates on the extension of the partial code freeze for ICD-9-CM and ICD-10 that are a result of the recent enactment of the Protecting Access to Medicare Act of 2014 (PAMA) (Pub. L. No. 113-93), which required CMS to delay implementation of ICD-10 until no earlier than October 1, 2015. Along with this announcement, CMS posted updated 2015 ICD-10-CM, ICD-10-PCS, and ICD-9 files as described in the paragraphs below:

Partial Code Freeze for ICD-9-CM and ICD-10 Extended 

The ICD-9-CM Coordination and Maintenance Committee implemented a partial freeze of the ICD-9-CM and ICD-10 (ICD-10-CM and ICD-10-PCS) codes prior to the implementation of ICD-10, which would end one year after the implementation of ICD-10. On April 1, 2014, the PAMA was enacted, which said that the Secretary may not adopt ICD-10 prior to October 1, 2015. Accordingly, HHS expects to release an interim final rule in the near future that will include a new compliance date that would require the use of ICD-10 beginning October 1, 2015. The rule will also require HIPAA covered entities to continue to use ICD-9-CM through September 30, 2015.

The partial code freeze will continue through October 1, 2015, the new planned implementation date. Regular updates to ICD-10 will begin on October 1, 2016, one year after the implementation of ICD-10. See Partial Code Freeze for ICD-9-CM and ICD-10 for more information.

2015 ICD-10-CM, ICD-10-PCS, and ICD-9-CM Files Available 

The 2015 ICD-10-CM and ICD-10-PCS files are now posted on the 2015 ICD-10-CM and GEMs web page and 2015 ICD-10-PCS and GEMs web page. There are no new, revised, or deleted ICD-10-CM or ICD-10-PCS codes.

The 2015 ICD-9-CM files are now available on the ICD-9-CM Diagnosis and Procedure Codes: Abbreviated and Full Code Titles web page. Since there will be no ICD-9-CM updates, there is no FY 2015 addendum. There are no new, revised, or deleted ICD-9-CM codes.

The 2015 General Equivalence Mappings (GEMs) will be posted later this summer.

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