Hospital Outpatient Quality Reporting Program Measures ...

Hospital Outpatient Quality Reporting Program Measures International Classification of Diseases, 10th Edition, Clinical Modification/Procedure Coding System (ICD-10/PCS) DRAFT Code Sets

CMS Seeks Informal Public Comment

To solicit feedback on the potential impact of transitioning from the ICD-9 Clinical Modification/ Procedure Coding System (ICD-9/PCS) to ICD-10/PCS on CMS' Hospital Inpatient Quality Measures, CMS is hosting an informal public comment period on the crosswalks of ICD-9 to ICD-10 codes used for these measures. This ensures that the Centers for Medicare & Medicaid Services (CMS) measure specifications continue to be of the highest caliber possible by utilizing a transparent process with input from relevant stakeholders. CMS will accept informal public comments until August 31, 2013 at 5 p.m. EDT.

This document contains the current ICD-9/PCS codes used in the Specifications Manual for National Hospital Outpatient Quality Measures cross-walked to the corresponding ICD-10 codes in table format. Specifically, we invite feedback on the relevancy and applicability of the ICD-10/PCS codes listed. Please submit comments via the email address listed below.

For all tables, submit comments to ICD10feedback@okqio..

TABLE OF CONTENTS

OP Table 1.1 Acute Myocardial Infarction (AMI) ....................................................... 1 OP Table 1.1a Chest Pain, Angina, Acute Coronary Syndrome Codes ...................... 4 OP Table 7.01 Mental Disorders ................................................................................. 4 OP Table 8.0 Ischemic and Hemorrhagic Stroke .................................................... 90 OP Table 9.0 Long Bone Fracture .......................................................................... 98

Hospital Outpatient Quality Reporting (HOQR) DRAFT ICD-9 to ICD-10 Crosswalks

The crosswalks provided below are for INFORMATION ONLY and ARE NOT to be programmed or submitted.

OP Table 1.1 ICD-9 CODE 410.00 410.01 410.01 410.10 410.11 410.11 410.11 410.11 410.20

Acute Myocardial Infarction (AMI)

ICD-9 DESCRIPTION Acute myocardial infarction of anterolateral wall, episode of care unspecified Acute myocardial infarction of anterolateral wall, initial episode of care Acute myocardial infarction of anterolateral wall, initial episode of care Acute myocardial infarction of other anterior wall, episode of care unspecified

Acute myocardial infarction of other anterior wall, initial episode of care

Acute myocardial infarction of other anterior wall, initial episode of care

Acute myocardial infarction of other anterior wall, initial episode of care Acute myocardial infarction of other anterior wall, initial episode of care Acute myocardial infarction of inferolateral wall, episode of care unspecified

ICD-10 CODE I21.09 I21.09 I22.0 I21.09 I21.01 I21.02 I21.09 I22.0 I21.19

ICD-10 DESCRIPTION ST elevation (STEMI) myocardial infarction involving other coronary artery of anterior wall ST elevation (STEMI) myocardial infarction involving other coronary artery of anterior wall

Subsequent ST elevation (STEMI) myocardial infarction of anterior wall ST elevation (STEMI) myocardial infarction involving other coronary artery of anterior wall ST elevation (STEMI) myocardial infarction involving left main coronary artery ST elevation (STEMI) myocardial infarction involving left anterior descending coronary artery ST elevation (STEMI) myocardial infarction involving other coronary artery of anterior wall Subsequent ST elevation (STEMI) myocardial infarction of anterior wall ST elevation (STEMI) myocardial infarction involving other coronary artery of inferior wall

Hospital OQR Specifications Manual DRAFT ICD-9 to ICD-10 Crosswalks

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OP Table 1.1 ICD-9 CODE 410.21 410.21 410.30 410.31 410.31 410.40 410.41 410.41 410.50 410.51

Hospital Outpatient Quality Reporting (HOQR) DRAFT ICD-9 to ICD-10 Crosswalks

Acute Myocardial Infarction (AMI) (continued)

ICD-9 DESCRIPTION Acute myocardial infarction of inferolateral wall, initial episode of care Acute myocardial infarction of inferolateral wall, initial episode of care Acute myocardial infarction of inferoposterior wall, episode of care unspecified Acute myocardial infarction of inferoposterior wall, initial episode of care

Acute myocardial infarction of inferoposterior wall, initial episode of care

Acute myocardial infarction of other inferior wall, episode of care unspecified

ICD-10 CODE I21.19 I22.1 I21.11 I21.11 I22.1 I21.19

Acute myocardial infarction of other inferior wall, initial episode of care Acute myocardial infarction of other inferior wall, initial episode of care Acute myocardial infarction of other lateral wall, episode of care unspecified Acute myocardial infarction of other lateral wall, initial episode of care

I21.19 I22.1

I2129 I21.29

ICD-10 DESCRIPTION ST elevation (STEMI) myocardial infarction involving other coronary artery of inferior wall

Subsequent ST elevation (STEMI) myocardial infarction of inferior wall

ST elevation (STEMI) myocardial infarction involving right coronary artery

ST elevation (STEMI) myocardial infarction involving right coronary artery

Subsequent ST elevation (STEMI) myocardial infarction of inferior wall ST elevation (STEMI) myocardial infarction involving other coronary artery of inferior wall ST elevation (STEMI) myocardial infarction involving other coronary artery of inferior wall Subsequent ST elevation (STEMI) myocardial infarction of inferior wall

ST elevation (STEMI) myocardial infarction involving other sites ST elevation (STEMI) myocardial infarction involving other sites

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OP Table 1.1 ICD-9 CODE 410.51 410.60 410.61 410.61 410.70 410.71 410.71

410.80

410.81 410.81 410.81

410.90

410.91

Hospital Outpatient Quality Reporting (HOQR) DRAFT ICD-9 to ICD-10 Crosswalks

Acute Myocardial Infarction (AMI) (continued)

ICD-9 DESCRIPTION Acute myocardial infarction of other lateral wall, initial episode of care True posterior wall infarction, episode of care unspecified True posterior wall infarction, initial episode of care True posterior wall infarction, initial episode of care Subendocardial infarction, episode of care unspecified Subendocardial infarction, initial episode of care

Subendocardial infarction, initial episode of care

Acute myocardial infarction of other specified sites, episode of care unspecified

ICD-10 CODE I22.8 I21.29 I21.29 I22.8 I21.4 I21.4 I22.2

I21.29

Acute myocardial infarction of other specified sites, initial episode of care Acute myocardial infarction of other specified sites, initial episode of care Acute myocardial infarction of other specified sites, initial episode of care Acute myocardial infarction of unspecified site, episode of care unspecified Acute myocardial infarction of unspecified site, initial episode of care

I21.21 I21.29 I22.8

I21.3

I21.3

ICD-10 DESCRIPTION Subsequent ST elevation (STEMI) myocardial infarction of other sites ST elevation (STEMI) myocardial infarction involving other sites ST elevation (STEMI) myocardial infarction involving other sites Subsequent ST elevation (STEMI) myocardial infarction of other sites Non-ST elevation (NSTEMI) myocardial infarction Non-ST elevation (NSTEMI) myocardial infarction Subsequent non-ST elevation (NSTEMI) myocardial infarction

ST elevation (STEMI) myocardial infarction involving other sites ST elevation (STEMI) myocardial infarction involving left circumflex coronary artery ST elevation (STEMI) myocardial infarction involving other sites Subsequent ST elevation (STEMI) myocardial infarction of other sites

ST elevation (STEMI) myocardial infarction of unspecified site

ST elevation (STEMI) myocardial infarction of unspecified site

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OP Table 1.1

ICD-9 CODE

410.91

OP Table 1.1a ICD-9 CODE 411.1 411.89

413.0 413.1

413.9 413.9 786.51 786.52 786.59 786.59 786.59

OP Table 7.01 ICD-9 CODE

290.0

290.10

290.11

Hospital Outpatient Quality Reporting (HOQR) DRAFT ICD-9 to ICD-10 Crosswalks

Acute Myocardial Infarction (AMI) (continued)

ICD-9 DESCRIPTION Acute myocardial infarction of unspecified site, initial episode of care

ICD-10 CODE I22.9

ICD-10 DESCRIPTION

Subsequent ST elevation (STEMI) myocardial infarction of unspecified site

Chest Pain, Angina, Acute Coronary Syndrome Codes

ICD-9 DESCRIPTION INTERMED CORONARY SYND AC ISCHEMIC HRT DIS NEC

ANGINA DECUBITUS PRINZMETAL ANGINA

ANGINA PECTORIS NEC/NOS ANGINA PECTORIS NEC/NOS PRECORDIAL PAIN PAINFUL RESPIRATION CHEST PAIN NEC CHEST PAIN NEC CHEST PAIN NEC

ICD-10 CODE I20.0

I24.8 I20.8

I20.1 I20.8 I20.9 R07.2 R07.1 R07.81 R07.82 R07.89

ICD-10 DESCRIPTION Unstable angina Other forms of acute ischemic heart disease Other forms of angina pectoris Angina pectoris with documented spasm Other forms of angina pectoris Angina pectoris, unspecified Precordial pain Chest pain on breathing Pleurodynia Intercostal pain Other chest pain

Mental Disorders ICD-9 DESCRIPTION SENILE DEMENTIA UNCOMP PRESENILE DEMENTIA PRESENILE DELIRIUM

ICD-10 CODE F03.90 F03.90 F03.90

ICD-10 DESCRIPTION Unspecified dementia without behavioral disturbance Unspecified dementia without behavioral disturbance Unspecified dementia without behavioral disturbance

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OP Table 7.01 ICD-9 CODE 290.12 290.12 290.13 290.13 290.20 290.20 290.21 290.3 290.40 290.40 290.41 290.42 290.43 290.8 290.9

Hospital Outpatient Quality Reporting (HOQR) DRAFT ICD-9 to ICD-10 Crosswalks

Mental Disorders (continued) ICD-9 DESCRIPTION PRESENILE DELUSION PRESENILE DELUSION PRESENILE DEPRESSION PRESENILE DEPRESSION SENILE DELUSION SENILE DELUSION SENILE DEPRESSIVE SENILE DELIRIUM VASCULAR DEMENTIA,UNCOMP VASCULAR DEMENTIA,UNCOMP VASC DEMENTIA W DELIRIUM VASC DEMENTIA W DELUSION VASC DEMENTIA W DEPRESSN SENILE PSYCHOSIS NEC SENILE PSYCHOT COND NOS

ICD-10 CODE F03.90 I67.3 F03.90 G30.9 F03.90 G30.9 F03.90 F03.90 F01.50 F01.51 F01.51 F01.51 F01.51 F03.90 F03.90

ICD-10 DESCRIPTION Unspecified dementia without behavioral disturbance Progressive vascular leukoencephalopathy Unspecified dementia without behavioral disturbance

Alzheimer's disease, unspecified Unspecified dementia without behavioral disturbance

Alzheimer's disease, unspecified Unspecified dementia without behavioral disturbance Unspecified dementia without behavioral disturbance Vascular dementia without behavioral disturbance Vascular dementia with behavioral disturbance Vascular dementia with behavioral disturbance Vascular dementia with behavioral disturbance Vascular dementia with behavioral disturbance Unspecified dementia without behavioral disturbance Unspecified dementia without behavioral disturbance

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OP Table 7.01 ICD-9 CODE 291.0 291.0 291.0 291.1 291.2 291.2 291.2 291.3 291.3

291.3 291.4

Hospital Outpatient Quality Reporting (HOQR) DRAFT ICD-9 to ICD-10 Crosswalks

Mental Disorders (continued) ICD-9 DESCRIPTION DELIRIUM TREMENS DELIRIUM TREMENS DELIRIUM TREMENS ALCOHOL AMNESTIC DISORDR ALCOHOL PERSIST DEMENTIA ALCOHOL PERSIST DEMENTIA ALCOHOL PERSIST DEMENTIA ALCOH PSY DIS W HALLUCIN ALCOH PSY DIS W HALLUCIN

ICD-10 CODE F10.121 F10.231 F10.921 F10.96 F10.27 F10.97 G31.2 F10.151 F10.232

ALCOH PSY DIS W HALLUCIN PATHOLOGIC ALCOHOL INTOX

F10.951 F10.929

ICD-10 DESCRIPTION

Alcohol abuse with intoxication delirium Alcohol dependence with withdrawal delirium Alcohol use, unspecified with intoxication delirium Alcohol use, unspecified with alcoholinduced persisting amnestic disorder Alcohol dependence with alcoholinduced persisting dementia Alcohol use, unspecified with alcoholinduced persisting dementia Degeneration of nervous system due to alcohol Alcohol abuse with alcohol-induced psychotic disorder with hallucinations Alcohol dependence with withdrawal with perceptual disturbance Alcohol use, unspecified with alcoholinduced psychotic disorder with hallucinations Alcohol use, unspecified with intoxication, unspecified

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