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UPDATE: CMS Announces ICD-10 Codes’ Impact on Medicare Quality Programs

Jan 18, 2017

UPDATE: On January 18, 2017, CMS released updated information and a list of FAQs.


December 15, 2016: On October 1, new ICD-10-CM and ICD-10-PCS code sets went into effect. As a result of the consolidated coding updates, a large number of new codes were added or removed. The Centers for Medicare and Medicaid Services (CMS) examined the impact to quality measures and determined that the updates will impact their ability to process data reported on certain quality measures for the fourth quarter of CY 2016.  Therefore, CMS will not apply the 2017 or 2018 PQRS payment adjustments, as applicable, to any eligible professional or group practice that fails to satisfactorily report for CY 2016 solely as a result of the impact of ICD-10 code updates on quality data reported for the fourth quarter of CY 2016.

What does this mean for you? You will be affected by this change ONLY If you were unable to satisfactorily participate in PQRS in 2016 because of ICD-10 code updates. CMS has not released the specific codes and measures included in this exclusion, so your Academy recommends continuing to meet your PQRS requirements.