Justification

Non-Substantive Change Request to CMS-2728

This is a non-substantive change request to Centers for Medicare and Medicaid Services (CMS) End Stage Renal Disease Medical Evidence Report, Medicare Entitlement and/or Patient Registration Form (CMS-2728) to allow CMS to collect International Classification of Diseases, Tenth Revision (ICD-10) Primary Cause of Renal Failure diagnosis codes on the CMS-2728 form. On October 1, 2014, the International Classification of Diseases, Ninth Revision (ICD-9) code sets used to report medical diagnosis will be replaced by ICD-10 medical diagnosis codes. The transition to ICD-10 is required for every entity covered by the Health Insurance Portability Accountability Act (HIPAA).

Currently, the CMS-2728 form collects ICD-9. With the implementation of ICD-10 effective on 10/1/2014; the current CMS 2728 form’s List of Primary Causes of End State Renal Disease (CMS-2728 Form Page 3 and Page 5 instructions only for item 15) need to be updated to reflect federal mandate of ICD-10.

The differences between ICD-9 and ICD-10 are significant as more diagnosis codes will be listed within CMS 2728 form with ICD-10 implementation.

We expect to receive approval for the updates CMS 2728 Form on or before May 1, 2014 so that CROWNWeb can ensure complete compliance with ICD-10 implementation. We therefore request approval of this request prior to May 1, 2014.