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ICD-9-CM Changes 2014

Recognizing the ICD-9-CM as a dynamic statistical tool that must be flexible to meet expanding classification needs, the ICD-9-CM Coordination and Maintenance Committee was created as a forum for proposals to update ICD-9-CM. A representative from the National Center for Health Statistics (NCHS) and one from the Centers for Medicare and Medicaid Services (CMS) co-chair the ICD-9-CM Coordination and Maintenance Committee meetings. Responsibility for maintenance of the ICD-9-CM is divided between the two agencies, with classification of diagnoses (volumes 1 and 2) by NCHS and of procedures (volume 3) by CMS.

Although the ICD-9-CM Coordination and Maintenance Committee is a Federal Committee, suggestions for modifications come from both the public and private sectors. Interested parties are asked to submit recommendations for modification prior to a scheduled meeting. Proposals for a new code should include a description of the code being requested, and rationale for why the new code is needed. Supporting references and literature may also be submitted. Proposals should be consistent with the structure and conventions of the classification.

These meetings are open to the public; comments are encouraged both at the meetings and in writing. Recommendations and comments are carefully reviewed and evaluated before any final decisions are made. No decisions are made at the meetings. 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. Final decisions are made after the December meeting and become effective October 1 of the following year. Official code revision packages, which are referred to as addenda, are available from the NCHS site.

ICD-9-CM Procedure Code Revisions

Issue: Describe the procedure and why current ICD-9-CM codes do not adequately capture the procedure

Background: provide detailed background information describing the procedure, patients on whom the procedure is performed, outcomes, any complications, and other relevant information. If this procedure is a significantly different means of performing a procedure that is already described in ICD-9-CM, this difference should be clearly described. The manner in which the procedure is currently coded should be described along with information from the requestor on why they believe the current code is not appropriate.

Options: Possible new or revised code titles should then be recommended.

ICD-9-CM Coordination and Maintenance Committee

Examples of procedure code background papers presented at the ICD-9-CM Coordination and Maintenance Committee meetings can be found in Summary Reports of previous meetings.

CMS staff will review and update the requestor's background paper for presentation at the C&M meeting. The CMS background paper will include a CMS recommendation on any proposed coding revisions; however, alternative suggestions will be considered at the meeting. The background paper is distributed for discussion at the C&M meeting and is also included in the summary report.

A presentation is made at the C&M meeting, which describes the clinical issues and the procedure. The requestor will be given the opportunity to provide a presenter, who may or may not be a physician, to make a presentation on the clinical nature of the procedure. CMS staff will lead a discussion of possible code revisions. The participants at the meeting are encouraged to ask questions concerning the clinical and coding issues and to offer recommendations. Recommendations concerning proposed code revisions made both in person at the C&M meeting, and in writing before the end of the comment period, will be considered. Final decisions on code revisions are made through a clearance process within the Department of Health and Human Services. No final decisions are made at the meeting.

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