CMS Announces Partial Freeze of ICD-9/ICD-10 Codes

Today, CMS released a notice regarding a partial freeze of ICD-9-CM/ICD-10 Code sets prior to the ICD-10-CM implementation on October 1, 2013.

According to the ICD-10-CM notice, the freeze will be implemented as follows:

The partial freeze will be implemented as follows:

                        • The last regular annual update to both ICD-9 and ICD-10 code sets will be made on October 1, 2011.

                        • On October 1, 2012 there will be only limited code updates to both ICD-9- CM and ICD- 10 code sets to capture new technology and new  diseases.

                        • There will be no updates to ICD-9 -CM on October 1, 2013 as the system will no longer be a HIPAA standard.

Transcripts of the ICD-9-CM Coordination and Maintenance Committee meeting can be found at: http://www.cms.gov/ICD9ProviderDiagnosticCodes/03_meetings.asp.

Although we expect that CMS will provide a ICD-9 to ICD-10 crosswalk of the CMS-HCC model at some point, we don’t know when that will happen. 

You can read the CMS notice here, on the Tools Page at HCCUniversity.com.

Changes to the CMS-HCC Model for 2011

As noted in our last post, the updated CMS-HCC Model codes were posted to our website on 9-29-2010.  You can view the file on our Tools Page.  But, what are the changes to the model for 2011?

In short, CMS has:

• Deleted two codes from the model --279.4 and 453.8.  Both of these codes are truncated codes, i.e., not at the highest level of specificity
• Deleted three codes from HCC 80--404.03, 404.93 and 404.13.  Note that these codes all still map to HCC 131
• Added 8 new codes to the model. All of these codes are new ICD-9 codes.  While the codes are effective 10-1-2010, they do not count in the CMS-HCC model until 1-1-2011.

See below for details.

ICD-9-CM Code	ICD9_Description	CMS-HCC Model Category	CMS HCC Model 2011	Action Taken	Comments
40413	Ben Hyp Ht/Kid W Hf/Kid	80	No	Deleted from this HCC	Although this diagnosis remains in the model under HCC 131, it no longer maps to HCC 80.
2794	Autoimmune Disease Nec	45	No	Deleted from the model	This diagnosis code was removed from the model. It is not at the highest level of specificity, and more specific codes in this section remain in the model.
4538	Venous Thrombosis Nec	105	No	Deleted from the model	This diagnosis code was removed from the model. It is not at the highest level of specificity, and more specific codes in this section remain in the model.
40493	Hyp Hrt/Kid Nos W Hf/Kid	80	No	Deleted from this HCC	Although this diagnosis remains in the model under HCC 131, it no longer maps to HCC 80.
40403	Mal Hyp Hrt/Kid W Hf/Kid	80	No	Deleted from this HCC	Although this diagnosis remains in the model under HCC 131, it no longer maps to HCC 80.
44770	Aortic ectasia, site NOS	105	Yes	Added	This is a new diagnosis code for 2011. The code is effective 10-1-2010, but not included in the model until 1-1-2011.
56032	Fecal impaction	31	Yes	Added	This is a new diagnosis code for 2011. The code is effective 10-1-2010, but not included in the model until 1-1-2011.
23773	Schwannomatosis	10	Yes	Added	This is a new diagnosis code for 2011. The code is effective 10-1-2010, but not included in the model until 1-1-2011.
23779	Neurofibromatosis NEC	10	Yes	Added	This is a new diagnosis code for 2011. The code is effective 10-1-2010, but not included in the model until 1-1-2011.
78033	Post traumatic seizures	74	Yes	Added	This is a new diagnosis code for 2011. The code is effective 10-1-2010, but not included in the model until 1-1-2011.
44773	Thoracoabd aortc ectasia	105	Yes	Added	This is a new diagnosis code for 2011. The code is effective 10-1-2010, but not included in the model until 1-1-2011.
44772	Abdominal aortic ectasia	105	Yes	Added	This is a new diagnosis code for 2011. The code is effective 10-1-2010, but not included in the model until 1-1-2011.
44771	Thoracic aortic ectasia	105	Yes	Added	This is a new diagnosis code for 2011. The code is effective 10-1-2010, but not included in the model until 1-1-2011.

If you have questions or comments about this posting, or have ideas for future postings, please let us know by leaving a comment!

New ICD-9 Codes Added to CMS-HCC Model

CMS published the new codes for the CMS-HCC model today on their website.  The new codes are effective 1-1-2011, and include a number of the new 2011 ICD-9 codes.  *While the ICD-9 codes are effective 10-1-2010, they are not included in the model until 1-1-2011.*

You can find the file on HCC University on our Tools Page.

The following codes have been added to the CMS-HCC or the RxHCC model:

Please note that there may be new codes added in 2011 due to changes in the CMS-HCC model.  The first (proposed) announcement of this will occur in February, with the final announcement of changes in April.  These changes will be posted here as soon as they become available.