How to Submit an ICD-10-CM Code Proposal | Process, Review & Approval

How does an ICD-10-CM code proposal go from an identified coding need to a possible new or revised diagnosis code? In this episode of AHCC Talk, Sherri Parson, RN, HCS-D, HCS-O, HCS-H, COS-C, and Sue Bowman, MJ, RHIA, CCS, FAHIMA, Senior Director, Coding Policy and Compliance with AHIMA, explain the ICD-10-CM code submission and approval process. Topics include: ✅ The organizations responsible for ICD-10-CM and ICD-10-PCS ✅ How to identify a true health information gap ✅ What information belongs in an ICD-10-CM code proposal ✅ The clinical, patient encounter, statistical/public health, and technical criteria considered ✅ How the ICD-10 Coordination and Maintenance Committee process works ✅ The role of public meetings and written comments ✅ Annual submission, review, and implementation timelines ✅ How health information professionals can participate in the process This episode's panel: ☑️ Jan Milliman, HCS-D, Director, AHCC ☑️ Sue Bowman, MJ, RHIA, CCS, FAHIMA, Senior Director, Coding Policy and Compliance AHIMA® ☑️ Sherri Parson, RN, HCS-D, HCS-O, HCS-H, COS-C, Owner, Parson Coding/Consulting LLC, and Regulatory Advisor, LSHERA ☑️ Lisa Selman-Holman, JD, BSN, RN, HCS-D, HCS-H, HCS-O, COS-C, Vice President of Clinical Services, McBee 0:45 Our Panel 2:17 ICD-10-CM Code Submission and Approval Process 2:25 What I’ll Cover 2:46 Cooperating Parties 4:54 One Committee, Two Code Sets, Distinct Stewards 6:42 ICD-10-CM Proposal-to-Code Pathway 8:17 ICD-10-CM Code Proposal Submission Process 9:19 Four Key Characteristics 11:28 Is There a True Health Information Gap? 13:27 Other Considerations for Proposal Submission 14:17 Four Tests 15:39 Public Participation Is Substantive 18:14 How an ICD-10-CM Proposal Advances 19:55 The ICD-10-CM Annual Cycle 21:40 Plan Backward from the Desired Implementation Year 22:16 ICD-10-CM Proposal Activity by Clinical Area 24:46 Takeaways for HI Professionals 26:21 Questions & Discussion 29:17 July PDGM Scenario and Answer 36:24 September Scenario 38:24 What’s New with AHCC Links Mentioned In The Episode 🔗 ⁠ICD-10-CM Coordination & Maintenance Committee⁠ https://www.cdc.gov/nchs/icd/icd-10-m... 🔗 ⁠ICD-10-CM code files, addenda, and guidelines⁠ https://www.cdc.gov/nchs/icd/icd-10-c... 🔗 ⁠CMS ICD-10 website⁠ https://www.cms.gov/medicare/coding-b... 🔗 ⁠AHA Coding Clinic⁠ https://www.codingclinicadvisor.com/ 🔗 Federal Register https://www.federalregister.gov/docum... 🔗⁠⁠⁠ Send completed proposal template by the submission deadline to ⁠nchsicd10cm@cdc.gov⁠ ⬇️ Downloadable slides from this discussion: https://ahcc.decisionhealth.com/media... 📧Have a question, episode request, or suggestions for a future panel guest? Email Jan at jan.milliman@decisionhealth.com