End of Grace Period Makes New ICD-10 Books Essential

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  • October 12, 2016
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End of Grace Period Makes New ICD-10 Books Essential

The ICD-10-CM grace period offered by Medicare and some private payers – allowing the submission of less specified codes without penalty – has ended, just as the Centers for Medicare & Medicaid Services (CMS) prepares to roll out more than 7,000 changes to the code set. Providers will need to update their ICD-10-CM and ICD-10-PCS medical code books as the agency starts looking for the most specificity in claims’ reported diagnoses.
The biggest change is in one of the most used, and universal diagnostic areas.

  • New deleted, and changed codes in diabetes
  • More than 300 changes in cancer codes
  • More than 400 changes in eye codes
  • Nearly 500 changes to orthopedic codes
  • More than 300 Uro/OB-Gyn code changes
  • Nearly 500 changes to newborn codes

There are also new, changed, and deleted codes for coma, skull fracture, and concussion. Feet are feeling heat this year, along with cardiovascular diagnoses codes.
There are nearly 400 new, change, and deleted injury, mortality, and family injury codes, which are also highly reported.
All of these changes will prompt an update to the Official Guidelines, which are essential to properly reporting these plentiful and complicated codes.

ICD-10-PCS Grace Ends, Also

In ICD-10-PCS, there are 3,651 new codes with approximately 1,750 other changes that were implemented on October 1, 2016. This includes the new Section X added last winter. This new code system for use by inpatient facilities will require additional vigilance by coders in 2017.

CPT and HCPCS Level II

Although it’s too early to know the exact changes in the AMA’s CPT and CMS’ HCPCS Level II code sets, effective January 1, 2017, each is expected to have 300 to 400 new, changed, and deleted codes.

Brad Ericson
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Brad Ericson, MPC, CPC, COSC, is a seasoned healthcare writer and editor. He directed publishing at AAPC for nearly 12 years and worked at Ingenix for 13 years and Aetna Health Plans prior to that. He has been writing and publishing about healthcare since 1979. He received his Bachelor's in Journalism from Idaho State University and his Master's of Professional Communication degree from Westminster College of Salt Lake City.

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