ICD-10: What You Need to Know

In fall of 2016, all health care providers, health plans and health care clearinghouses will have one year of ICD-10 coding under their belt. On Oct. 1, 2016, the Centers for Medicare and Medicaid Services (CMS) will release over 5,500 ICD-10 codes for the fiscal year (FY) 2017, including around 1,900 diagnosis codes (ICD-10-CM) and 3,651 hospital inpatient procedures codes (ICD-10-PCS).  The increased number of codes comes after CMS lifted the partial code freeze and all the new codes developed over the past several years are being released for 2017. Most of the new hospital inpatient codes pertain to cardiovascular procedures. The changes for cardiovascular codes were made to create unique device values for multiple intraluminal devices and for applying the qualifier “bifurcation” to multiple root operations for all artery body part values.

How will these new hospital codes impact cardiovascular professionals? 

It will be imperative that all health care providers document very clearly so that coders can determine the correct medical procedures performed.  Coders have to be able to determine the Operation, Body Part, Approach, Device and Qualifierperformed.  All health care providers and coders should review the new coding guidelines and codes every year to make sure they use the most up-to-date language and codes.  A draft of the new inpatient codes is available below to help you start preparations in your office now. 

One example of a change can be seen in the bypass section of the heart and great vessels (Heart and Great Vessels 021 – 02Y; Operation {Character 3} – Bypass {1}).  These procedure codes are already in ICD-10-PCS for FY 2016 but CMS has added the device (Character 6) Zooplastic Tissue to a number of codes. Another example of a change can be seen in the same section with a revision of the wording in the code descriptions; the sequencing stays the same:

From To

0211093 – Bypass Coronary Artery, Two Sites from Coronary Artery with Autologous Venous Tissue, Open Approach

0211093 – Bypass Coronary Artery, Two Arteries from Coronary Artery with Autologous Venous Tissue, Open Approach

ICD-10 Codes and Guidelines
The National Center for Health Statistics, Centers for Disease Control and Prevention and CMS provide the "ICD-10-CM Official Guidelines for Coding and Reporting" using ICD-10-CM. These guidelines are a set of rules that accompany and complement the official conventions. Review the 2016 ICD-10 codes and the individual notes around your codes.  Also you can periodically check this website for the release of FY 2017 codes.

Resources for Navigating ICD-10 Changes 

ACC Resources

Latest CMS Resources (Updated May 2016)

Additional Provider Resources on ICD-10 Cardiovascular Coding

Partner Resources