May 22, 2023 Release Notes

The annual updates to the CMS Readmission and Mortality Focused Population were implemented with the November 2022 release. At that time, the Yale ICD-10 Code Appendix did not exclude COVID-19 patients from the CMS Pneumonia Readmission and Mortality focused population. Yale has since updated the specifications to now exclude COVID-19 patients from the CMS Pneumonia Readmission and Mortality focused population.

To stay in alignment with Yale and not wait until the next annual fall Focused Population update, QualityAdvisor will be updating the ICD-10 Focused Populations (Current) folder with the latest FY23 Pneumonia focused population. The previous population from the Current prompt folder will be shifted to the Historical prompt folder with the FY21-FY22 tag.

Summary of Focused Population updates (ICD-10 Code Appendix updates):

Pneumonia - CMS Readmission and Mortality COVID Exclusion

• U07.1 – Pneumonia (Readmission Pop) Exclusions

• Patients will be excluded if the principal diagnosis is COVID or if they have a secondary diagnosis of COVID that was present on admission.

Two Premier-defined focused populations will be updated based on the new codes that CMS recently released, effective with 4/1/2023 discharges.

• 12 Procedure Codes Added for Spinal Fusion Cervical/Other Upper Back & Neck Procedures

0P530Z3 - Destruction of cervical vertebra using laser interstitial thermal therapy, open approach

0P533Z3 - Destruction of cervical vertebra using laser interstitial thermal therapy, percutaneous approach

0P534Z3 - Destruction of cervical vertebra using laser interstitial thermal therapy, percutaneous endoscopic approach

0P540Z3 - Destruction of thoracic vertebra using laser interstitial thermal therapy, open approach

0P543Z3 - Destruction of thoracic vertebra using laser interstitial thermal therapy, percutaneous approach

0P544Z3 - Destruction of thoracic vertebra using laser interstitial thermal therapy, percutaneous endoscopic approach

0Q500Z3 - Destruction of lumbar vertebra using laser interstitial thermal therapy, open approach

0Q503Z3 - Destruction of lumbar vertebra using laser interstitial thermal therapy, percutaneous approach

0Q504Z3 - Destruction of lumbar vertebra using laser interstitial thermal therapy, percutaneous endoscopic approach

0Q510Z3 - Destruction of sacrum using laser interstitial thermal therapy, open approach

0Q513Z3 - Destruction of sacrum using laser interstitial thermal therapy, percutaneous approach

0Q514Z3 - Destruction of sacrum using laser interstitial thermal therapy, percutaneous endoscopic approach

• 2 Procedure Codes Added for Vascular Surgery

02LW0DJ - Occlusion of thoracic aorta, descending with intraluminal device, temporary, open approach

04L00DJ - Occlusion of abdominal aorta with intraluminal device, temporary, open approach

An updated ICD-10 Code Appendix document and an updated Pneumonia flowchart are available on the ICD-10 Focused Populations (Current) page.