American College Of Surgeons - Inspiring Quality: Highest Standards, Better Outcomes

NTDB/TQIP Transition to AIS 05 (08 Update) and ICD-10 FAQ

When will TQIP expect ICD-10 implementation?

The NTDS currently accepts ICD-10 codes, but they will not be accommodated in the TQIP report until fall 2015. Furthermore, they won’t be mandatory until 2017 or later, per WHO standards.

 

Do we have a date yet as to when TQIP and NTDB will require ICD 10 coding?

The US Government has scheduled implementation of ICD-10 for October 2015. Currently, TQIP and NTDB have the capability to receive both ICD-9 and ICD-10 codes.

We encourage centers to make the transition to ICD-10 in accordance with the government deadline. However, we will continue to accept ICD-9 for admissions through December 31, 2016.

Please review our current data dictionary at www.ntdsdictionary.org for more information on ICD-10 inclusion criteria and data elements affected by the transition.

 

When it's time to start ICD-10, will you be having us submit both ICD-9 & ICD-10 or just one or the other?

TQIP and NTDB will require ICD-10 exclusively starting with January 1, 2017 admissions.

Although we have been equipped to accept ICD-10 codes for the past few years, TQIP and NTDB will begin using patient data coded with ICD-10 starting with October 1, 2015 admissions in accordance with the CMS deadline.  Please note that, as hospitals transition to this new version, we are also making the transition across our database and reporting structures.  We will keep our participants posted on our progress toward ICD-10, and will carefully document use of versions in our reports, etc.

Also important to note, as previously announced we will require AIS05 exclusively starting with January 1, 2016 admissions. 

We are not asking hospitals to dual code.  Please submit either ICD-9 or ICD-10, but not both.

 

How long are ICD-9 codes accepted?

TQIP and NTDB will require ICD-10 exclusively starting with January 1, 2017 admissions.

 

Please clarify the statement “Although……TQIP and NTDB will begin using patient data coded with ICD-10 starting with October 1, 2015 admissions in accordance with the CMS deadline. “  

Does this mean any patient prior to Oct 1, 2015 that had an ICD-10 code was not included in any of the reports or does this mean patient’s with an Oct 1, 2015, and forward, admission date that have an ICD-9 code will be “cross-walked” to ICD-10?

To date, we have not reported on patients that are coded in ICD-10.  Our current plan is to report on ICD-10 coded patients starting with October 1 admissions.  However, if we receive significant ICD-10 data in the current call for data, we will consider using ICD-10 data sooner, if possible. Please note that the spring 2016 report will cover patients through the third quarter of 2015, so it would not yet include admissions from October 1 and later.

For a period of time, we know we will be getting patients coded in both ICD-9 and 10, and we have a transition plan that will allow us to use both versions in reporting.

 

I am in search of the required ICD-10 code sets that will be required to report to your database. The dictionary was very vague, I am looking for a more standard code set or range of codes that will need to be submitted so we can update our reports in our EHR.

We do not maintain a standard code set for information to be submitted as the codes can span the entirety of ICD-10-CM.  The diagnosis codes that we accept are outlined in our inclusion criteria contained in our data dictionary. 

 

Would a dual-coded (in ICD-9 and ICD-10) 4th quarter of 2014 be acceptable for the purpose of avoiding a mixed ICD9/ICD10 submission? We’ve received word today that our state may be mandating a switch to ICD-10 coding on 10/1.

That would be acceptable.

 

Do you have any opinion or preference on NTDB submissions coded alternately in ICD-9 and ICD-10? “Alternately” meaning some months (like the first nine months of this year) in ICD-9 and some (the last three months of this year) in ICD-10. Our facility is planning on changing over to ICD-10 on or before the deadline and we’re trying to get a handle on whether we want to switch over with them in the registry or continue on in ICD-9 for the entirety of 2015.

We do have a preference – if you would finish your 2015 in ICD-9, that would be best for us.  We are trying to avoid mixed-year submissions as much as we can.

 

I would like to inquire about ICD-10. Our Trauma Service staffs will attend ICD-10 class, and on their application form, we were asked if we want to buy ICD-10-CM (diagnosis classification system), ICD-10-PCS (procedure classification system), or both. I am under the impression that if coding injuries using ICD-10, we must also use ICD-10 to code our procedures.

You should use the same coding for both.

 

In the ACS NTDB Data Dictionary for 2016, page 9 lists the inclusion and exclusion criteria. Some of the codes indicate to include only those with specific 7th character modifiers. If this is not specified, such as with T07 and T14, do we include patients with any codes that start with those 3 characters but have any other combination of letters and numbers added on to it? For example, T14 is not a billable code, but T14.8, T14.90, and T14.91 are. Would all of those codes indicate patients to be screened for inclusion in the registry?

The codes that you specified qualify for inclusion.  The 7th character modifier specifically speaks to the types of modifiers that are eligible for inclusion – we specifically want to look at initial encounters and not sequelae or subsequent encounters.  If the code does not include any digits or modifiers past the digits shown (like your example of T14.8 or T14.90) then it’s fine as long as it falls in the S and T range and doesn’t fall as the only injury code within the specified exclusion criteria (superficial wounds, mostly).

 

I have been tasked to ask about ICD-10 coding of diagnostic imaging (i.e. CT scans, ultrasound, x-rays). Is it a mandatory requirement to submit ICD-10 codes of diagnostic imaging to NTDB and/or TQIP?

Diagnostic imaging falls under procedure codes which are covered under ICD-10.  Please see the ICD-10 Procedure codes page in the NTDS Data Dictionary for more information on how to collect diagnostic imaging.

 

Can you say when the ICD-10-CM will be included in the NTDB datasets?

ICD-10 data will be included in datasets starting with admission year 2015 data. That dataset will be available for purchase in the fall of 2016.

 

Why are the definitions for ICD-10 codes in the submission frequency report listed as “(Definition Not Available)?”

The ICD-10 definitions for codes are fairly long with three levels and they do not print out in the submission frequency report.  This is not due to anything you have done incorrectly.