Next meeting of ICD-10-CM Coordination and Maintenance Committee is March 19-20, 2014

Post #282 Shortlink: http://wp.me/pKrrB-3xE

The deadline for receipt of public submissions in response to proposals for updates and changes to ICD-10-CM diagnosis and procedure codes presented at the September 18-19, 2013 meeting of the ICD-9-CM Coordination and Maintenance Committee has now closed.

In 2014, this advisory Committee, which is co-chaired by NCHS and CMS, will be known as the ICD-10-CM Coordination and Maintenance Committee, as there will be no further updates of ICD-9-CM.

A done deal?

Proposals submitted on behalf of the American Psychiatric Association (APA) and presented at the meeting by APA’s Research Director, Darrel Regier, MD, can be found from Page 32 of the Diagnosis Agenda. Additional proposals for inclusion of new DSM-5 disorder terms within ICD-10-CM Chapter 5 Mental and behavioral disorders can be found on Pages 45-46.

The Summary of the September meeting diagnosis presentations can be found here. Links for the four videocasts of the meeting’s two day proceedings are listed in this Dx Revision Watch post and the Meeting Materials are here.

The Timeline for ICD-9-CM (for the remainder of its life) and for ICD-10-CM is set out from Page 3 of the Diagnosis Agenda.

Some diagnosis proposals at the September 18-19, 2013 meeting were requested for October 2014 implementation and some for 2015 implementation. I shall update this site when the outcomes of the various proposals are published, next year.

There is a lack of clarity over which body has requested the addition of Somatic symptom disorder (SSD) and Illness anxiety disorder as inclusion terms to existing ICD-10-CM codes. It isn’t clear whether these two additional DSM-5 constructs have been proposed for inclusion in ICD-10-CM by the APA or by the NCHS/CMS Committee – if the latter, should we assume these two proposals already have the support of NCHS?

Given APA’s determination to achieve harmonization between the two systems, the outcome of its proposals to insert a handful of new DSM-5 disorders into ICD-10-CM may already be a done deal between APA and NCHS: the Director of NCHS may not need much persuasion to ratify their retrofitting into ICD-10-CM.

Loss of public trust and confidence

If NCHS is planning to rubber stamp insertion into ICD-10-CM of DSM-5’s poorly validated Somatic symptom disorder in response to APA diktat, having conducted no field testing and in the absence of a body of supportive evidence for SSD’s clinical relevance, safety and utility, and with disregard for a high level of public concern, what confidence can the public have that this federal agency is meeting its duty of care towards patient populations and towards the clinicians and allied health professionals who may deploy this proposed new ICD term, in its ethics, integrity and methods and for upholding standards of scientific rigour?

APA may re-present proposals next year

If APA is unsuccessful with any of the additions requested via the September meeting, it is possible that the organization may re-present proposals or modified proposals at the next C & M Committee meeting, scheduled for March 19-20, 2014. There are also other new DSM-5 disorders or changes that APA might potentially propose for incorporation into ICD-10-CM at the March 2014 or the September 2014 meeting, or at some later point.

Only a brief public submission period for March 2014 meeting

March 19-20, 2014 meeting

The deadline for Requestors to submit proposals for consideration for the March meeting agenda is January 17, 2014.

The draft agenda will be posted in February 2014.

Registration is required for those wishing to attend the meeting. Register online between on February 14 – March 14.

The two day meeting is scheduled for March 19 – 20.

Note: the deadline for receipt of comments on the March 19-20, 2014 meeting proposals for both procedure and diagnosis codes and changes is given as April 18. So instead of a couple of months for stakeholder responses, it appears there will only be four weeks or so in which to prepare and submit comments or objections.

I will post the Diagnosis Agenda for the March 2014 meeting as soon as it becomes available and links for the videocasts of the proceedings after the meeting has taken place. (Videocasts now substitute for written transcripts of meeting proceedings.)

Extracts from the Timeline that relate to the publication of additions and changes for ICD-10-CM:

April 2014 Notice of Proposed Rulemaking to be published in the Federal Register as mandated by Public Law 99-509. This notice will include references to the complete and finalized FY 2015 ICD-10-CM diagnosis and ICD-10-PCS procedure codes. It will also include proposed revisions to the MS-DRG system based on ICD-10-CM/PCS codes on which the public may comment. The proposed rule can be accessed here.

June 2014 Final addendum posted on web pages as follows:

Diagnosis addendum – http://www.cdc.gov/nchs/icd/icd10cm.htm
Procedure addendum – http://cms.hhs.gov/Medicare/Coding/ICD10/index.html

October 1, 2014 New and revised ICD-10-CM and ICD-10-PCS codes go into effect along with DRG changes. Final addendum posted on web pages as follows:

Diagnosis addendum – http://www.cdc.gov/nchs/icd/icd9cm_addenda_guidelines.htm
Procedure addendum – http://www.cms.gov/Medicare/Coding/ICD9ProviderDiagnosticCodes/addendum.html

November 2014 Any new ICD-10 codes required to capture new technology that will be implemented on the following April 1 will be announced. Information on any new codes to be implemented April 1, 2015 will be posted on the following websites:

http://www.cms.gov/Medicare/Coding/ICD9ProviderDiagnosticCodes/addendum.html

http://www.cdc.gov/nchs/icd/icd9cm_addenda_guidelines.htm

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