Too Many Codes, Not Enough Time During Coordination and Maintenance Committee Virtual Meeting

The Coordination and Maintenance Committee meetings were held virtually on Sept. 8 and 9. For proposals presented for an April 1, 2021 effective date, comments are due by Oct. 9, 2020. For proposals presented for an Oct. 1, 2021 effective date, comments are due by Nov. 9, 2020.  Comments may be emailed to ICDProcedureCodeRequest@cms.hhs.gov for the procedure codes and nchsicd10cm@cdc.gov for the diagnosis codes.

The meeting began with the procedure topics under the guidance of the Centers for Medicare and Medicaid Services (CMS). The topics included this year were the following:

• Administration of Lifileucel, Idecabtagene vicleucel (ide-cel), Narsoplimab, and CAR T-cell Immunotherapy
• Chimeric Antigen Receptor T-cell Immunotherapies
• Embolic Protection
• Antibiotic-eluting Bone Void Filler
• Posterior Dynamic Spinal Stabilization
• Restriction of Coronary Sinus
• Single Use Duodenoscope During ERCP
• Spinal Stabilization
• Vertebral Body Tethering
• Section X Update
• Classification Addenda

During this meeting, CMS discussed the frequency analysis of fourteen X codes that were implemented in years 1 and 2 of ICD-10-PCS for fiscal years 2016 through 2019. The analysis included if the code was approved for New Technology Add-On Payment (NTAP). CMS is looking for feedback regarding potential retirement or movement to outside of the New Technology Section. No changes have been made to these procedure codes to date.

After the procedure meeting on Sept. 8, the National Center for Health Statistics (NCHS) began the diagnosis portion of the meeting.The thirty-seven topics for this portion of the meeting included the following:

• Abnormal Findings of Blood Amino-Acid Level
• Acute Flaccid Myelitis
• Allergy to Mammalian Meats
• Anaplastic Large Cell Lymphoma, ALK Negative of the Breast
• Cervicogenic Headache
• Complication of Immune Effector Cellular (IEC) Therapy
• Cough
• COVID-19 Issues
• Depression NOS
• Endometriosis
• Esophageal Polyp
• Fournier Disease of Vagina and Vulva
• Gastrointestinal Metaplasia
• Hematopoietic Stem Cell Transplant-Associated Thrombotic Microangiopathy
• Hemolytic-Uremic Syndrome (Typical and Atypical)
• Hereditary Alpha Tryptasemia
• Immune Effector Cell Associated Neurotoxicity Syndrome (ICANS)
• Lipedema and Lipolymphedema
• Lumbar and Lumbosacral Intervertebral Annular Fibrosis Defects
• Mild Cognitive Disorder Due to Known Physiological Conditions
• Moisture Associated Skin Damage
• Multisystem Inflammatory Syndrome
• Niemann-Pick Disease (NPD) Type A and B
• Nocturnal Polyuria
• Non-Radiographic Axial Spondyloarthritis
• Pneumonia due to COVID-19
• Post-Procedure Anastomotic Leak of Digestive System Organ or Structure Following Procedure
• Pyruvate Kinase (PK) Deficiency
• Rapid Destructive Osteoarthritis
• Refractory Angina Pectoris
• Short Bowel Syndrome and Intestinal Failure
• Short Stature Due to Endocrine Disorder
• Thrombocytosis and Essential Thrombocythemia
• Vertebrogenic Pain
• Vulvovaginal Candidiasis (Recurrent)
• Addenda

The meeting continued from Sept. 8 through Sept. 9 with not enough time to complete the full agenda. It was noted that all topics are available for comment even if they were not presented. There are a few topics that requested implementation for April 1, 2020 which include:  Multisystem Inflammatory Syndrome, Pneumonia due to COVID-19, and Other COVID-19 Issues. 

It is important to review the proposal and provide comments regarding the ICD-10-CM and ICD-10-PCS code development. The new codes will impact your organization’s data, the coders, and clinical documentation integrity specialists in the coming years. The recordings have not been posted as of Sept. 13, 2020, but they should be posted the coming week for review to assist with your comments.

Resources:

https://www.cms.gov/Medicare/Coding/ICD10/C-and-M-Meeting-Materials#09082020

https://www.cdc.gov/nchs/icd/icd10cm_maintenance.htm