What Was Missing at the ICD-10 C&M Meeting?

Much was covered during the ICD-10 Coordination and Maintenance Committee (C&M) meeting last week at the Centers for Medicare & Medicaid Services (CMS) headquarters in Baltimore.

The first striking item was that there were no procedure proposals made during this meeting. There was discussion about three root operations – creation, control, and extraction. The definition of the root operation of creation was changed for the 2017 fiscal year, to include the heart and great vessels body system for the creation of new cardiac valves with current tissue due to congenital deformities.   

It was suggested that the change in the root operation was inappropriate, and thereafter it was proposed that this definition should be returned to its original form. The recent changes to the root operation of control have led to a public request of adding the root operation to the ear/nose/sinus body system.  

This comment suggested that “control” was meant to apply to general body parts, and the appropriate body system to add the root operation to would be anatomical regions, general. The index addendum was discussed with regard to aspiration biopsies, which now have an entry for extraction, diagnostic. This discussion centered on the confusion of using “extraction” for bone marrow, with the fluid extracted coded to the drainage root operation. There was also the thought that the proposed entries might create confusion for coders. Comments were suggested before the addendum was finalized.  

Another discussion that was meaningful for coders focused on the root operation of fusion. It was stated during the meeting that the fusion tables were being updated, and the “no device value” was being removed from the fusion tables. The use of this root operation requires a device to be considered a fusion. The removal of this value should make the choices more straightforward for coders.

The ICD-10-PCS Index and Table were also reviewed with internal and public suggestions. The table suggestions focused on expanding qualifiers and adding brand names for the devices. Many of the updates included typographical corrections as well.  

There is a YouTube video of the meeting that can be found online at https://www.cms.gov/Medicare/Coding/ICD9ProviderDiagnosticCodes/ICD-9-CM-C-and-M-Meeting-Materials-Items/2017-09-12-MeetingMaterials.html?DLPage=1&DLEntries=10&DLSort=0&DLSortDir=descending. The ICD-10-PCS materials can be found at https://www.cms.gov/Medicare/Coding/ICD9ProviderDiagnosticCodes/Downloads/2017-09-12-Agenda.pdf.    

Comments are due to CMS regarding procedures by Nov. 13, 2017. There will be no procedures added to the code set in April 2018, based on there being no requests for this status.   

The diagnosis portion of this meeting encompassed one and a half days. The diagnosis portion of the meeting was more substantial and will be covered in Part 2 of this series.

PROGRAM NOTE: Listen to Laurie Johnson live tomorrow, Sept. 19, 10-10:30 a.m. ET on Talk Ten Tuesdays as she reports live on the outcome of last week’s C&M meeting.