HAVE YOU EVER wondered how a code becomes a code? Thinking about this question can easily bring to mind the Schoolhouse Rock classic “I’m Just a Bill.” If you become inspired to write your own rendition of “I’m Just a Code,” you can find all the information you need to do so on the Centers for Medicare and Medicaid Services (CMS) website. The ICD- 10 Coordina- tion and Maintenance Committee meets twice a year to discuss code changes. These meetings are streamed live and worth tak- ing the time to watch. It is incredibly interesting to see the key stakeholders discuss new technologies, procedures, and clinical issues. Not only do they discuss code changes in these meetings, but the history and reasoning behind the changes are presented
as well. It often happens that a doctor will provide detailed information on conditions and procedures that would be difficult
to find elsewhere. It is so helpful to understand what you are
coding and why it is important to select the most appropriate
code. Even better, you can get free CEUs for watching.
CMS handles the ICD-10-PCS code process and the Centers for
Disease Control and Prevention (CDC) handles the ICD-10-CM
code process. Both agencies do a great job of crosslinking their
websites so it is easy to access the meeting information. To review
meeting materials for the ICD- 10 Coordination and Maintenance
Committee (C&M), go to the page titled “ICD- 10 C and M Meeting
Materials” at www.cms.gov/Medicare/Coding/ICD9ProviderDi-
agnosticCodes/ ICD-9-CM-C-and-M-Meeting-Materials.html. Do
not be alarmed when you see that the URL still has “ICD-9-CM” in
it. It will still take you to the listing of the ICD- 10 meeting materials.
For each meeting you will find an agenda and handouts in the
downloads section of the web page. Each agenda contains de-
tailed information on the codes proposed during that meeting
as well as important dates relating to the C&M and the ICD-10-
PCS codes. ICD-10-PCS index and table information for the up-
coming October changes may also be included.
The screenshot in Figure 1 on page 69 shows the March 2018
C&M meeting materials page and where you can find the
handouts, as well as an excerpt from the agenda for a meeting.
The May 2018 Coding Notes article “Understand CMS Outpa-
tient Hospital Edits in 10 Minutes or Less” discussed the National
Correct Coding Initiative (NCCI) hospital procedure to procedure
(PTP) edits. There are also practitioner PTP edits. Those edits can
be found using the same URLs mentioned in that article. Each
quarter, a new version of the edits is released, available at www.
Coding-Edits.html. When coding for physician services, these are
the PTP edits coding professionals will want to use to help decide
when CPT/HCPCS codes may or may not be assigned together.
CMS also provides the Medicare Physician Fee Schedule files
and a handy look-up tool on their physician fee schedule web
page at www.cms.gov/apps/physician-fee-schedule/overview.
aspx. In the look-up tool, a coding professional can search by
code to find code information relating to the fee schedule.
For example, the screenshot of the look-up tool in Figure 2 on
page 70 provides information on laterality, global period, and
Along with all the information above and in the previous articles of this Coding Notes series, CMS provides yet another
fantastic resource—the Medicare Claims Processing Manual.
This manual explains the history of instruction for hospital
Utilizing the CMS Website for
Additional Coding Direction
By Megan DeVoe, CCS
Editor’s Note: This is the final article in a three-part series on how to master the information available on the Centers for Medicare
and Medicaid Services website.