New Diagnosis and Procedure Codes on the Horizon!

The next Coordination and Maintenance (C&M) Committee meeting will be held on Sept. 12 and 13 . This meeting will be virtual, and you must register to attend. The meeting will begin with the procedure proposals and continue to the diagnosis proposals. The schedule is 9 a.m.-5 p.m. each day, with a lunch break from 12:30-1:30 p.m..

The tentative procedure agenda was posted by the Centers for Medicare & Medicaid Services (CMS) Aug. 11. The agenda includes seven items, including Section X Updates and Addenda and Key Updates. There are also two items up for proposed procedure code consideration, but they will not be presented at the virtual meeting. The slides and proposal information are available on the C&M materials website.

The following procedure items will be presented at the meeting, in addition to Section X Updates and Addenda and Key Updates:

1. Irreversible Electroporation for Cardiac Ablation, for which the applicant is requesting an April 2024 implementation date and plans to apply for New Technology Add-On Payment (NTAP) status for the 2025 fiscal year (FY).
2. Computer-Aided Anesthesia and Oxygen Delivery System, with the applicant planning to apply for NTAP status for 2025 FY.
3. Insertion of Palladium-103 Radioactive Implant, for which an April 2024 implementation date is requested.
4. Introduction of Bone Void Filler, for which the applicant is planning to apply for NTAP status for 2025 FY.
5. Electrical Biocapacitance for Assessment of Pressure Injuries, for which the applicant is applying for NTAP status in 2025 FY and an April 2024 implementation date.

These two items below will not be presented at the meeting. The applicants are requesting an April 1, 2024 implementation date. Both applicants plan to submit for NTAP status for 2025 FY:

1. Administration of Iodine (131I)-apamistamab, which treats acute myeloid leukemia (AML); and
2. Administration of Talquetamab, which treats relapsed/refractory multiple myeloma.

The tentative agenda for the diagnosis codes was published on Aug. 14. The tentative agenda contains 28 proposals, plus the addenda. Some of these proposals include:

1. Baked egg/milk intolerance
2. Family history of familial adenomatous polyposis
3. Flank anatomical specificity
4. Nasal valve collapse
5. Cement and fat pulmonary emboli
6. Pediatric body mass index
7. Personal history of colonic polyps
8. Post-exertional malaise
9. Serotonin syndrome
10. Usher syndrome
11. Early-stage type 1 diabetes
12. Coding of firearm injuries default
13. Cholestatic pruritis
14. Injection drug use

The tentative agenda provides instructions for joining the Coordination and Maintenance Committee meeting’s Govdelivery Subscriber List. This method is the best way to get notifications of upcoming C&M meetings.

Final decisions are not made during the C&M meeting on diagnosis or procedure codes. Your comments are encouraged. If you attend the meeting, your written comments must be submitted for consideration. Oct. 13, 2023 is the deadline to submit written public comments on proposed new codes and revisions for April 2024 implementation. Nov. 15 is the deadline for written public comments for the ICD-10-CM and PCS codes scheduled for Oct. 1, 2024 implementation.

ICD-10-CM and PCS codes scheduled for April 1, 2024 implementation will be published in November 2023. The early notification permits vendors, software engineers, and revenue cycle staff to prepare for the implementation. The final code addenda will be published in February 2024.

The deadline for submitting new code applications for the March 2024 Coordination and Maintenance Committee meeting is Dec. 1, 2023. The next meeting will be held March 19 and 20, 2024.

Resources:
2023-09-12-ICD10-Meeting-Materials | CMS
Tentative Agenda September 2023 (cdc.gov)
Registration Link: https://cms.zoomgov.com/webinar/register/WN_lWLKuwKzQU6iJdvcDvXhdA