The ICD-10 Freeze is Over: 2017 ICD-10-CM/PCS Coding updates and the Impact on Clinical Documentation Improvement

The 2017 ICD-10 coding updates went into effect on October 1, 2016. The partial ICD-10 code freeze also ended in late 2016 and thousands of mandated code updates for ICD-10-CM and ICD-10-PCS went into effect at that time. These updates have an impact on clinical documentation improvement. In brief, these code updates occurred at the same time that CMS lifted the moratorium on issuing denials for incorrect code assignments.

The cost component of the MACRA / MIPS program will be based on 2017 claims data. Coding accuracy with appropriate documentation to support it therefore becomes paramount to successful revenue cycle management. Hopefully everyone used the year of ICD-10 flexibility to improve documentation to a level that supports a higher specificity of coding. Unspecified codes still exist but code assignment of unspecified codes should be limited and occur only in instances when clinical documentation is unknown or unavailable. Complete and accurate documentation will ensure optimal revenue and data integrity while effectively demonstrating the quality of care provided.

In summary, the one-year anniversary of the implementation of ICD-10 and the subsequent 2017 code updates are an opportune time to perform audits of documentation and coding to assess the need for documentation improvement efforts and education for coders, physicians and other providers. Consistent reviews and education will facilitate accurate coding, timely claims submissions and appropriate reimbursement. If you would like more information regarding these updates, request a recording of our October 2016 Podcast webinar that took place on October 20, 2016. The webinar discussed significant ICD-10 changes and how they relate to documentation guidelines. Learning objectives for the webinar included:

• Increasing understanding of the 2017 ICD-10 coding updates and guidelines.
• Identifying documentation gaps related to the 2017 coding updates
• Utilizing concepts learned to develop education for providers

If you would like further information on how Coker can assist you will clinical documentation improvement or coding updates please contact us to speak with Annette Sullivan, Senior Manager.