It’s a problem that pops up far more often than anyone would expect: you’re attempting to code a new set of documentation when you discover that the patient’s incredibly specific issue is not covered by a current ICD-10 code. Though it may be hard to fathom given that ICD-10 contains over 70,000 codes, this issue is far from infrequent, to the point that there is an entire committee that holds regular meetings dedicated to continuously updating the massive code set. And the best part? Anyone can attend the meetings and submit a proposed amendment.
Since 2014, the ICD-10 Coordination and Maintenance Committee–led by representatives from both the National Center for Health Statistics (NCHS) and the Centers for Medicare and Medicaid Services (CMS)–has met to discuss and vote upon potential code changes. With NCHS responsible for the clinical modification (CM) side and CMS in charge of the procedural coding system (PCS), this committee meets every March and September to sort through proposals. Though there was a temporary freeze on coding updates during the transition to ICD-10, that pause is long over, and the committee is once again accepting amendments from the general public. Final decisions regarding updates and revisions are made by the Department of Health and Human Services, but submitting to this ICD-10 committee is the first major step in making a change.
To submit a change for consideration, simply prepare a brief proposal containing a description of the proposed code change, the reasoning (including clinical relevance) for why you think the code should be altered, and any supporting medical documentation or other references that will help argue your case. Once you have submitted your proposal, be sure to register for the next available meeting (always held at the CMS headquarters in Baltimore, Maryland) so that you can see your revisions being reviewed firsthand. If you are unable to attend in person, public comments on all proposals can be submitted online up to a month after each session.
For examples of proposals from previous meetings, visit the official ICD-10 Coordination and Maintenance Committee webpage.