CMS is finalizing its proposal to create two new MS-DRGs for endovascular cardiac valve procedures with and without MCC, according to the fiscal year 2020 IPPS final rule.
Peggy S. Blue, MPH, CCS, CCS-P, CPC, CEMC, writes that one of the most interesting aspects of the ICD-10-CM code update for fiscal year (FY) 2020 was CMS’ proposal to change the severity assignment for many of these codes. In this article, Blue compares the severity changes that were suggested in the FY 2020 IPPS proposed rule with the designations that were actually finalized.
Q: We recently had a patient who was admitted with sepsis and the physician documented sepsis, a urinary tract infection (UTI) related to a chronic Foley catheter, and pneumonia. Can we report sepsis first instead of the complication code, or is the complication always first?
If payment updates in the 2020 Medicare Physician Fee Schedule proposed rule are finalized, they will significantly impact physician reimbursement for x-ray and E/M CPT codes, among others. Review payment proposals and the specialties that would see the greatest impact.
Q: Would it be appropriate to query the provider for clarification if documentation for an orbital fracture doesn’t specify the location of the fracture and whether it is open or closed?
The American Medical Association released the 2020 CPT code set on August 26, introducing 248 new codes including many for drug implants, dry needling, and cardiac drainage procedures.
