ICD-10 Coding Freeze Is Over

James Swann 154x154

Just as the Ice Age eventually ended, so has the ICD-10 coding freeze. CMS recently announced that roughly 6,000 new codes will be added this October, which will be the first coding update since October 2011. The coding update is significantly bigger than previous updates to the ICD-9 codeset, which often included 50 or fewer new codes.

I spoke with Scot Nemchik, vice president of coding education at CIOX Health, who told me that while the size of the update seems alarming at face value, the growth is largely driven by the addition of five new medical procedures, requiring several new codes.

The five new procedures, which Nemchik said covered 75 percent of the new codes, are for face and hand transplants, bypasses involving animal tissue, new body part valves, thrombectomy procedures performed on arterial bifurcations and root operation dilation in the lower arteries and body arteries.

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Under the old ICD-9 codeset, a procedure like a coronary artery bypass often had one code attached. Under ICD-10, Nemchik said coders are required to denote such details as the specific artery where the bypass took place and the surgical approach used in the procedure, Nemchik said.

As a result, a single new medical procedure, such as the use of animal tissue in bypasses, will result in dozens of new codes. Nemchik said that while the number of new codes might seem big, coders won’t have to learn them all but will instead focus on the underlying new procedure.

Nemchik told me that the ICD-10 rollout has been smooth, but did say that productivity has declined by 25% due to the level of detail needed for the new codes. Nemchik said it also remains to be seen how accurate ICD-10 coded claims prove to be, noting that RACs had great success in finding inaccuracies in ICD-9 coded claims.

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Photo courtesy of: Bloomberg News

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