New CMS Policy in Effect for Quality Measures Impacted by ICD-10 Updates

Finalized in the CY 2018 Quality Payment Program (QPP), the Centers for Medicare and Medicaid Services (CMS) established a new protocol for quality measures impacted by changes in ICD-10 coding. This new protocol went into effect on October 1, 2019.

ICD-10 coding updates go into effect on October 1, while quality measures cannot be changed until the next MIPS performance year on January 1. Changes to clinical guidelines can affect the overall performance score of physicians participating in MIPS. If CMS determines there is a significant impact on a quality measure, quality measure performance scores will be based solely on the first 9 months of the performance year.

The two quality measures CMS has identified as being significantly impacted by changes in ICD-10 codes are: Atrial Fibrillation and Atrial Flutter; Chronic Anticoagulation Therapy (326) and HRS-12: Cardiac Tamponade and/or Pericardiocentesis Following Atrial Fibrillation Ablation (392). Both measures will only be evaluated based on the first nine months of the performance year in 2019.

The final rule establishing this process can be found here. More information about MIPS quality measure reporting requirements can be found here.


For more information visit the McDermottPlus Payment Innovation Resource Center or contact Sheila Madhani at 202-204-1459 or