CMS Announces Partial Code Freeze Ahead of ICD-10 Transition

Now that the U.S. Department of Health & Human Services has issued a new compliance date for the transition to ICD-10 codes in the United States, the Centers for Medicare & Medicaid Services (CMS) has announced additional preparations leading up to it. The final rule, published in July, set the new American compliance date for Oct. 1, 2015. The new codes must be used by all entities covered by the Health Insurance Portability & Accountability Act (HIPAA).

Last week, CMS issued a Medicare Learning Network (MLN) Matters bulletin regarding a partial code freeze prior to the ICD-10 implementation.

On Oct. 1, 2014, “there will be only limited code updates to both the ICD-9-CM and ICD-10 code sets to capture new technologies and diseases as required by section 503(a) of Pub. L. 108-173,” the bulletin said. These limited code updates also took place on Oct. 1, 2012 and Oct. 1, 2013 – making Oct. 1, 2011, the final regular annual update to the two code sets until the transition.

Similarly, on Oct. 1, 2015, the day ICD-10 implementation takes place in the United States, there will be limited code updates to the ICD-10 set. No further updates to the ICD-9 code set will take place.

On Oct. 1, 2016, the MLN Matters article said, regular ICD-10 updates will begin.

“The ICD-9-CM Coordination and Maintenance Committee will continue to meet twice a year during the partial freeze,” the bulletin said. “At these meetings, the public will be asked to comment on whether or not requests for new diagnosis or procedure codes should be created based on the criteria of the need to capture a new technology or disease. Any code requests that do not meet the criteria will be evaluated for implementation within ICD-10 on and after October 1, 2016 once the partial freeze has ended.”

ICD-10 diagnostic and procedural codes will replace the current ICD-9 codes. The diagnostic ICD-10 alphanumeric codes have three to seven characters, compared to the three to five digits that numerical ICD-9 diagnostic codes have. The new code set allows for updated, more accurate descriptions and new diagnoses, whereas the ICD-9 set had run out of room for new codes.

The transition in the United States to ICD-10 codes, created by the World Health Organization, has been delayed several times. Many other nations, including Canada, Australia, China and Great Britain, have been using the ICD-10 set of codes for more than a decade.

For more CMS-related information on the ICD-10 transition, click HERE.

About the Author

Laurie Watanabe is the editor of Mobility Management. She can be reached at lwatanabe@1105media.com.

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