CMS Process for Requesting New/Revised ICD-10-PCS Procedure Codes

Guidance for submitting input for process for requesting new/revised ICD-10-PCS Procedure Codes.

Effective March 1, 2022, the electronic intake system, Medicare Electronic Application Request Information System™ (MEARIS™), became active for ICD-10-PCS code request submissions. The ICD-10-PCS code request application can be accessed at: https://mearis.cms.gov.  CMS only accepts ICD-10-PCS code request applications submitted via MEARIS™. 

Within MEARIS™ there are several resources built in to support requestors:

• Please refer to the “Resources” section for guidance regarding the request application submission process at: https://mearis.cms.gov/public/resources.
• Technical support is available under “Useful Links” at the bottom of the MEARIS™ site
• Request application related questions can be submitted to CMS using the form available under “Contact” at: https://mearis.cms.gov/public/resources?app=icd-10-pcs
• The time required for request application submission, including the time needed to gather relevant information as well as to complete the form may be extensive depending on the nature of the code request. Requestors are therefore encouraged to start in advance of the due date to ensure adequate time for submission. 

The ICD-10 Coordination and Maintenance Committee may not be able to consider all procedure code requests received for the next Committee Update and will determine if it would be appropriate to postpone consideration of any procedure code requests to a future time.

The responses provided to the questions in MEARIS™ for a new ICD-10-PCS procedure code(s) request will be used to automatically populate a background paper that provides detailed information describing the procedure (that is, any service, technology, treatment, or administration of a therapeutic agent, etc.), the steps involved in the performance of the procedure, outcomes, any complications, and other relevant information. If the procedure uses a significantly different means or method of performing the procedure than is currently reflected in the procedure ification, this difference should be clearly described. The responses provided within MEARIS™ should also include a description of the patients on whom the procedure is performed, the typical care setting in which the procedure is performed, and which diagnosis/diagnoses the procedure is indicated to address. The documentation and terminology that would likely be found in the medical record to assist coders in identifying the procedure and how the procedure is currently coded should be described along with information from the requestor on why it is believed the current code(s) is not appropriate.  Recommendations for possible new or revised code titles may also be submitted by the requestor for CMS’ consideration. 

Within MEARIS™, requestors indicate if the code request is for consideration for an April 1 implementation date or an October 1 implementation date. The  ICD–10 Coordination and Maintenance Committee makes efforts to accommodate the requested implementation date for each request submitted. However, the Committee determines which requests are to be considered for an April 1 implementation date or an October 1 implementation date. In addition, requestors indicate whether they are submitting or intend to submit a New Technology Add-on Payment (NTAP) policy application related to the ICD-10-PCS procedure code request. If an NTAP application is not submitted as indicated,  is withdrawn, or deemed ineligible, the Committee will determine if it would be appropriate to postpone consideration of the procedure code request to a future time.

After the procedure code requests received through MEARIS™ are reviewed, all requestors will be contacted as to whether the request has been approved for consideration in association with the next ICD-10 Coordination and Maintenance Committee Update, or if the request has been postponed. If approved, CMS staff will coordinate with each requestor to update the background paper and assist with the current coding and proposed coding options for inclusion in the procedure code topic materials that will be made publicly available on the ICD-10 C and M Procedure Code Materials web page. The background paper will also include a CMS recommendation on the proposed coding options to facilitate public comments.

CMS staff will also coordinate with requestors to record a presentation that describes the clinical aspects of the specified procedure code topic. The recorded clinical presentation is limited to 10 minutes and will be made publicly available on the ICD-10 C and M Procedure Code Materials web page.  For each procedure code request topic recording, CMS staff will follow the clinical presentation with a review of the proposed coding options. 

Members of the public are encouraged to submit comments indicating support or opposition for the proposed coding options. CMS also encourages the public to submit any questions concerning clinical or coding issues for a specified topic. Comments on all procedure code related issues should be directed to the CMS mailbox at: ICDProcedureCodeRequest@cms.hhs.gov by the designated deadline.  Recommendations submitted by e-mail before the end of the comment period will be considered.  

No decisions are made before the end of the public comment period. The ICD-10 Coordination and Maintenance Committee's role is advisory. All final decisions are made through a clearance process within the Department of Health and Human Services.