The Centers for Medicare and Medicaid Services (CMS) and the ICD-9-CM Coordination and Maintenance Committee held a meeting on September 16, 2009 to discuss the future of ICD-10-CM/PCS. Some of the topics discussed at the meeting were the ICD-10-CM/PCS MS-DRG conversion project, freezing of the ICD-9-CM code updates and the General Equivalence Mappings (GEMS).

An open discussion was held regarding the freezing of the International Classification of Diseases, 9th Edition (ICD-9) code updates prior to the October 1, 2013 implementation for ICD-10. The purpose of the meeting was for the Committee to obtain the publics opinion on freezing ICD-9 updates. CMS has decided to grant the public additional time to submit written comments regarding the freezing of ICD-9 and updates to ICD-10-CM/PCS on any or all of the following related issues:

1. Should ICD-9 updates be frozen prior to the October 1, 2013 implementation of ICD-10-CM and ICD-10-PCS?
2. Should ICD-10-CM/PCS be frozen prior to the October 1, 2013 implementation of ICD-10-CM and ICD-10-PCS?
3. At what point should the updating of ICD-10-CM/PCS begin again (e.g., October 1, 2014 (FY 2015)?
4. What ICD-10 coding products are vendors developing (e.g., ICD-10-CM/PCS code books, encoders, automated mapping applications based on the General Equivalence Mappings)?
5. Currently the CMS abbreviated code titles are limited to 24 characters. With the longer ICD-10-CM/PCS code titles, should consideration be given to expanding these codes titles? If so, how long should the ICD-10-based titles be?

To view the questions in their entirety, please visit the CMS website. No deadline for submission of comments has been provided at this time. The Society will be submitting comments on the issues listed above. If you would like to comment on the above issues, please submit your commentsto Pat Brooks at patricia.brooks2@cms.hhs.gov or Donna Pickett at dfp4@cdc.gov.

MS-DRGs, IPPS, GEMs

The committee also discussed the topics of Medicare Severity-Diagnostic Related Group (MS-DRGs), Inpatient Prospective Payment System (IPPS), General Equivalence Mappings (GEMS) and the undertaking of converting from ICD-9 to ICD-10-PM/PCS.

CMS has stated that the ICD-10 draft version of MS-DRGs will be completed in October 2009. The final ICD-10 versions of the MS-DRGs will be subject to formal rulemaking as part of the Inpatient Prospective Payment System (IPPS).

The IPPS proposed rule will be discussed in the spring of 2010. The public will be given an opportunity to formally comment on the issues relating to the IPPS proposed rule at that time. CMS will format a proposal(s) based on the public comments received.

Undertaking of the conversion project from ICD-9 to ICD-10 will be a vital part in successfully implementing ICD-10-CM/PCS in your practice. Computer programmers and other technical personnel will be needed to ensure training. Personnel with clinical coding expertise, data analysis, and detailed knowledge of the practical use of the application will be helpful for transition. The use of the GEMS will also be a vital undertaking for the conversion of ICD-9 to ICD-10.

GEMs were developed as a tool to assist with the conversion of International Classification of Diseases, 9th Edition, Clinical Modification (ICD-9-CM) codes to International Classification of Diseases, 10th Edition (ICD-10) and the conversion of ICD-10 codes back to ICD-9-CM. The GEMs are forward and backward mappings between the ICD-9-CM and ICD-10 coding systems and are also referred to as crosswalks since they provide important information linking codes of one system with codes in the other system. The intended audience for the GEMs includes coding professionals, payers, providers, medical researchers, informatics professionals as well as any other individuals who use coded data. Annual updates to the GEMs will be posted in January of every calendar year. The Committee will continue to discuss updating the GEMs for a period of up to three years after the ICD-10 implementation date of October 1, 2013.

The Diagnosis and Procedure General Equivalence Mappings (GEMS) User’s Guide can be found on the CMS website at the following links:

• Web page containing 2009 ICD-10-CM files with information on the new diagnosis coding system, ICD-10-CM, that is being developed as a replacement for ICD-9-CM, Volumes 1 and 2 — visit CMS website
• Web page containing 2009 ICD-10-PCS files with information on the new procedure coding system, ICD-10-PCS, that is being developed as a replacement for ICD-9-CM, Volume 3 — visit CMS website

Transition and Conversion from ICD-9 to ICD-10-PM/PCS

The Heart Rhythm Society aims to increase member awareness of the new ICD-10-CM/PCS and recognizes that implementation planning is vital in the transitioning from ICD-9 to ICD-10. To assist our members, the Society has developed a strategy list of ideas that may be useful during the transitioning period:

• Establish a planning team with a team leader
• Develop an internal timeline and implementation plan
• Conduct impact analysis
• Contact system vendors
• Estimate a budget plan
• Develop a training plan (Education)
• Documentation improvement
• Establish a communication plan
• Policy change development plan
• Deployment of ICD-10 codes
• Implementation of the new ICD-10 compliance