October 1, 2015 was seen as doomsday by many in the healthcare industry. It was compared to Y2K and the Mayan calendar. But, like those other situations, most clinics and payers sailed right through, leaving many of us wondering why it seemed like such a big deal. ICD-11 is expected to be released by the World Health Organization in 2018, but it will take the National Center for Health Statistics several more years before they are ready to release the Clinical Modification for use in the United States. In the meantime, however, ICD-10-CM will be updated annually in order to keep up with the changing needs of our healthcare system.

Who is in charge of these updates?

March 9-10, 2016, the ICD-9-CM Coordination and Maintenance Committee met to discuss changes to ICD-10-CM, which begins October 1, 2016 at the earliest. A representative from the National Center for Health Statistics (NCHS - part of the CDC) and one from the Centers for Medicare and Medicaid Services (CMS) co-chair the meetings. NCHS is responsible for classification of diagnoses while CMS is responsible for ICD-10-PCS (which are used only in an inpatient/facility setting at this time).

The ICD-9-CM Coordination and Maintenance Committee's role is advisory. All final decisions are made by the Director of NCHS and the Administrator of CMS at the end of the year and become effective October 1 of the following year.

Official code revision packages, which are referred to as addenda, are available from the CDC. The agenda for the March 2016 meeting included 1,928 proposed new codes for ICD-10-CM, and around 5,500 for ICD-10-PCS, but the official addendum is not released until June 2016. Deadline for public comments on proposed new codes from the March meeting was April 8, 2016.

A few of the new codes (such as codes for the Zika virus) may be fast-tracked for addition on October 1, 2016, but most will likely go into effect in 2017.

How can I suggest code changes?

The ICD-9-CM Coordination and Maintenance Committee meets twice a year. At these meetings, the public is asked to comment on whether or not requests for new diagnosis or procedure codes should be created based on the criteria of the need to capture a new technology or disease. Although it is a Federal Committee, suggestions for modifications come from both the public and private sectors. Interested parties must submit proposals for modification prior to a scheduled meeting via http://www.cdc.gov/nchs/icd/icd9cm_maintenance.htm.

Proposals for a new code should include the following:

Proposals should be consistent with the structure and conventions of the classification. In other words, submitters need to know how ICD-10-CM works and figure out how their idea fits into the existing format.

The next meeting is Sept. 13-14, 2016, with proposals due July 15, 2016. If accepted, these proposals would not go into effect until 2017, at the earliest.

What I really want to know is, will I need to buy a new ICD-10 code book?

It depends on your specialty. There are some significant changes proposed for myocardial infarction, lump in the breast, and type 2 diabetes, among others. If you use an online encoder library, such as Find-A-Code, you can rest easy because codes are always current since they are updated as soon as changes are made official. Many publishers, such as the InstaCode Institute, are hard at work on specialty specific 2017 ICD-10 books, which may be pre-ordered, but won't ship until this fall once the code updates are made official. Note that after a year of using ICD-10, many things have been learned and publications should contain specific tips and tricks to make your job a little easier. Even though the codes may not have changed much, the tools and advice available gets better every year.

Dr. Evan M. Gwilliam, DC, MBA, BS, CPC, NCICS, CCPC, CCCPC, CPC-I, MCS-P, CPMA,
is a licensed physician with a master's in business administration. He is also a certified professional coding instructor, compliance specialist, and medical auditor. Dr. Gwilliam has published articles in multiple trade journals and travels the country to deliver training to physicians and staff on coding, documentation, and compliance. He is the Executive Vice President at FindACode.