ICD-9-CM is an official classification system that practitioners currently use to code diagnoses and procedures on health care claim forms in the United States. Organizations use ICD-9-CM codes from claim and encounter data to identify diagnoses and procedures for HEDIS reporting. The Centers for Medicare & Medicaid Services (CMS) has mandated that health care providers switch from ICD-9 to ICD-10 Diagnosis and Procedure codes, effective October 1, 2014.
To accommodate this change, NCQA created a plan to identify a valid and appropriate set of ICD-10 codes for each HEDIS measure in time for inclusion in the HEDIS 2015 publications. This identification has been in progress for three years and is now complete. NCQA seeks public comment on the final recommendations for converting ICD-9 to ICD-10 codes in HEDIS measures.
NOTE: This process and timeline is separate from the HEDIS Public Comment process and timeline.
Reviewing the Recommendations
Because of the large number of codes being reviewed, NCQA is providing reviewers with more time than usual to look at the recommendations and provide comments and suggestions. We suggest that reviewers look at the recommendations and submit comments in sections or phases. Reviewers are asked to submit their comments in writing using the ICD-10 Public Comment form by 9:00am (ET) on Monday, December 16, 2013.