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ICD-10-CM/PCS News for:
February 1, 2018

Disclosing protected health information for minors

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ICD-10-CM coding of pathological fractures

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ICD-10-CM/PCS News Archives

ICD-10-CM Now Used in Physician Quality Reporting

September 16, 2015:

Medicare’s physician quality reporting system is another example of the far reaching impact of the change to ICD-10-CM coding. Beginning Oct. 1, 2015, quality reporting measures will incorporate ICD-10-CM codes. In this case, ICD-10-CM codes replace ICD-9-CM codes as the denominators that reflect the group of patients eligible for receiving care addressed in the quality reporting measures.

In general, quality measures consist of a unique denominator identifying an eligible patient and numerator describing the clinical action taken. Using this information, Medicare calculates, at the provider level, the percentage of patients who meet that criteria and receive a specified process of care or clinical outcome/result. It is important to review and understand each measure specification, especially as it pertains to a specific reporting option.

To comply with quality measure rules effective 10/1/2015, practices need to confirm that their reporting of quality measures reflects the new ICD-10-CM denominator codes. Optum360’s Physician Reporting Guide includes both ICD-9-CM and ICD-10-CM denominator codes. For more information see: https://www.optum360coding.com/Product/43559/


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