July 12, 2013
by admindxrw
ICD-10-CM Release for 2014 now available
Prior to implementation, the codes in ICD-10-CM are not valid for any purpose or use.
The World Health Organization’s (WHO) International Classification of Diseases (ICD-10) was published in 1992 and is used in over a hundred countries worldwide.
A number of countries have been authorized by WHO to develop “Clinical Modifications” – adaptations of ICD-10 for country specific use. These differ in the number of chapters, codes and subcategories. Specific conditions are present in some adaptations but not all clinical modifications [1]. All modifications to the ICD-10 must conform to WHO conventions for ICD.
Canada uses an adaptation called ICD-10-CA, Australia uses ICD-10-AM, Germany uses ICD-10-GM and Thailand uses ICD-10-TM.
The U.S. lags behind most of the rest of the world and is still using a Clinical Modification of the WHO’s long since retired, ICD-9.
A U.S. specific adaptation of ICD-10 has been under development for a considerable length of time but is scheduled for implementation on October 1, 2014.
Transition to ICD-10-CM is required for everyone covered by the Health Insurance Portability Accountability Act (HIPAA).
Implementation schedules for Large Practices; Small and Medium Practices; Small Hospitals and Payers can be found on the CMS website, here: Implementation Timelines.
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2014 release of ICD-10-CM
The 2014 release of ICD-10-CM is now available from the CDC website. It replaces the July 2012 release.
Prior to the implementation date of October 1, 2014, the codes in ICD-10-CM are not valid for any purpose or use.
The ICD-10-CM code set is currently subject to partial code freeze. For information on the code freeze see Partial Freeze of Revisions to ICD-9-CM and ICD-10-CM/PCS.
October 1, 2011 was the last major update of ICD-10-CM/PCS until October 1, 2015. Between October 1, 2011 and October 1, 2015, revisions to ICD-10-CM/PCS will be for new diseases/new technology procedures or minor revisions to correct any reported errors in these classifications. Regular (at least annual) updates to ICD-10-CM/PCS will resume on October 1, 2015.
Information on the ICD-9-CM and ICD-10-CM/PCS update and revision processes and the public NCHS/CDC Coordination and Maintenance Committee meetings can be found on this CDC page: Coordination and Maintenance Committee.
Downloading the ICD-10-CM code sets
The ICD-10-CM Preface, Guidelines, Tabular List, Index and associated documentation can be downloaded from this page: http://www.cdc.gov/nchs/icd/icd10cm.htm#10update.
The PDF of the Preface is in a single PDF file here: ICD-10-CM Preface 2014
The PDF of the Guidelines is in a single PDF file here: ICD-10-CM Guidelines
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To access the PDFs for the ICD-10-CM Tabular List and Index, the files need extracting from Zip files from this link:
ICD-10-CM List of codes and Descriptions (updated 7/3/2013)
( ftp://ftp.cdc.gov/pub/Health_Statistics/NCHS/Publications/ICD10CM/2014/ )
Select this file, below, on the CDC site and open it. It is a large file of over 15MB so you will need to allow sufficient time for it to fully load:
06/19/2013 08:28AM 15,223,965 ICD10CM_FY2014_Full_PDF.zip
It will unpack these five PDF files, which can be opened and viewed in situ or saved:
ICD10CM_FY2014_Full_PDF_DIndex 4,222 KB [ICD-10-CM INDEX TO DISEASES and INJURIES]
or open unzipped PDF on Dx Revision Watch: ICD-10-CM 2014 Full Index
ICD10CM_FY2014_Full_PDF_EIndex [401 KB] [ICD-10-CM External Cause of Injuries Index]
ICD10CM_FY2014_Full_PDF_TableOfDrugs [2,193 KB]
ICD10CM_FY2014_Full_PDF_TableOfNeoplasms [646 KB]
ICD10CM_FY2014_Full_PDF_Tabular [7, 398 KB] [ICD-10-CM TABULAR LIST of DISEASES and INJURIES]
or open unzipped PDF on Dx Revision Watch: ICD-10-CM Tabular List
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For five PDF files of Addenda go to this page:
ftp://ftp.cdc.gov/pub/Health_Statistics/NCHS/Publications/ICD10CM/2014/
and select this file:
06/19/2013 08:28AM 582,584 ICD10CM_FY2014_Addenda.zip
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Comparison between classifications and codings in ICD-10-CM and ICD-10
The WHO’s ICD-10 Volume 1 The Tabular List isn’t made available as a PDF file but can be accessed on a searchable electronic browser platform here: ICD-10 Version: 2010.
The Tabular List for ICD-10 contains more textual descriptions for the categories in Chapter V (the mental and behavioural disorders chapter) than other chapters in ICD-10.
There are also two “speciality” volumes for ICD-10 Chapter V for Clinical descriptions and diagnostic guidelines (known as the “Blue Book”) and Diagnostic criteria for research (known as the “Green Book”).
The U.S. specific ICD-10-CM will not contain this depth of textual content within its Chapter 5.
CDC’s, Donna Picket, has confirmed that CMS/CDC does not plan to adapt the “Blue Book” specifically for U.S. use in conjunction with Chapter 5 of ICD-10-CM [2]. Nor are there plans for an official CMS/CDC crosswalk between ICD-10-CM’s Chapter 5 classifications and codes and those in ICD-10 Chapter V [3].
In the U.S., since 2003, the ICD-9-CM diagnostic codes have been mandated for third-party billing and reporting by HIPAA for all electronic transactions for billing and reimbursement. Following implementation on October 1, 2014, the ICD-10-CM codes sets will become mandatory.
This also applies to the coding of mental and behavioural disorders. APA’s DSM-IV disorder diagnoses are crosswalked to ICD-9-CM codes, or their nearest equivalent, for billing and reimbursement.
The DSM-5, published in May this year, includes the crosswalk codes for both the existing ICD-9-CM and the forthcoming ICD-10-CM codes.
For comparison between
ICD-10-CM Chapter 5 Mental, Behavioral and Neurodevelopmental disorders (F01-F99)
and ICD-10 Chapter V Mental and behavioural disorders (F00-F99) see the ICD-10 online browser or
The ICD-10 Classification of Mental and Behavioural Disorders Clinical descriptions and diagnostic guidelines (The “Blue Book”)
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References and further resources
1. The development, evolution, and modifications of ICD-10: challenges to the international comparability of morbidity data. Jetté N, Quan H, Hemmelgarn B, Drosler S, Maass C, Moskal L, Paoin W, Sundararajan V, Gao S, Jakob R, Ustün B, Ghali WA; IMECCHI Investigators. Med Care. 2010 Dec;48(12):1105-10. doi: 10.1097/MLR.0b013e3181ef9d3e [PMID: 20978452].
The development, evolution and modifications of ICD-10: challenges to the international comparability of morbidity data: Nathalie Jetté MD, November 2009, Slide Presentation [5 MB].
2. Personal communication.
3. Personal communication.
4. Information for providers, payers and vendors on transition to ICD-10-CM can be found here on the CMS website.
5. DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services: ICD-10-CM/PCS MYTHS AND FACTS ICN 902143, April 2013.
6. American Psychological Association: Nine frequently asked questions about DSM-5 and ICD-10-CM, APA Practice staff answer questions about billing, determining diagnoses and more related to the two diagnostic classification systems. Practice Update, May 16, 2013.
7. American Psychiatric Association: Insurance Implications of DSM-5
8. AAPC What is ICD-9-CM?
dx revision watch 
Next meeting of ICD-10-CM Coordination and Maintenance Committee is March 19-20, 2014
November 16, 2013 by admindxrw
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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Filed under American Psychiatric Association (APA), Darrel Regier, Diagnostic classification, DSM-5, ICD-10-CM, ICD-11, MUS, Somatic Symptom Disorder, Somatoform Disorders, WHO Collaborating Centre Tagged with american psychiatric association, dsm-5, icd-10-cm, icd-11, illness anxiety disorder, institute of psychiatry, NCHS, public comment, somatic symptom disorder, somatoform disorders