ICD-10-CM Official Guidelines for Coding and Reporting – FY2020 – Released

Mary Madison, RN, RAC-CT, CDP
Clinical Consultant – Briggs Healthcare

Late afternoon on Thursday, August 8, 2019, CMS released the ICD-10-CM updates for FY 2020 with this announcement:

“These 2020 ICD-10-CM codes are to be used for discharges occurring from October 1, 2019 through September 30, 2020 and for patient encounters occurring from October 1, 2019 through September 30, 2020.

Note: There is no FY 2020 GEMs file. As stated in the FY 2016 IPPS/LTCH PPS final rule (80 FR 49388), the GEMs have been updated on an annual basis as part of the ICD-10 Coordination and Maintenance Committee meetings process and will continue to be updated for approximately 3 years after ICD-10 is implemented.

We made the GEMs files available for FY 2016, FY 2017 and FY 2018.

An announcement was also made at the September 2017 ICD-10 Coordination and Maintenance Committee meeting that FY 2018 would be the last GEMs file update.”

This is what you’ll see in the Downloads section when you click on the hyperlink in the opening statement of this blog:

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The ICD-10-CM Official Guidelines for Coding and Reporting are 121 pages in length.

“These guidelines should be used as a companion document to the official version of the ICD-10-CM as published on the NCHS website…These guidelines are a set of rules that have been developed to accompany and complement the official conventions and instructions provided within the ICD-10-CM itself. The instructions and conventions of the classification take precedence over guidelines. These guidelines are based on the coding and sequencing instructions in the Tabular List and Alphabetic Index of ICD-10-CM, but provide additional instruction. Adherence to these guidelines when assigning ICD-10-CM diagnosis codes is required under the Health Insurance Portability and Accountability Act (HIPAA). The diagnosis codes (Tabular List and Alphabetic Index) have been adopted under HIPAA for all healthcare settings. A joint effort between the healthcare provider and the coder is essential to achieve complete and accurate documentation, code assignment, and reporting of diagnoses and procedures. These guidelines have been developed to assist both the healthcare provider and the coder in identifying those diagnoses that are to be reported. The importance of consistent, complete documentation in the medical record cannot be overemphasized. Without such documentation accurate coding cannot be achieved. The entire record should be reviewed to determine the specific reason for the encounter and the conditions treated… Only this set of guidelines, approved by the Cooperating Parties (American Hospital Association-AHA, American Health Information Management Association-AHIMA, CMS and National Center for Health Statistics-NCHS), is official.”