The FY 2017 IPPS proposed rule includes updates to payment rates and quality initiatives, but some of the most extensive changes pertain to proposals for certain MS-DRG classifications and relative weights.
The FY 2017 IPPS proposed rule released April 27 is replete with modifications and expansions to claims-based quality and cost outcome measures. Although many of these proposed changes are for future fiscal years, ICD-10 codes reported for current discharges will impact the future financial performance for our organizations.
On April 18, CMS issued its anticipated IPPS proposed rule for FY 2017. This year's proposed rule is very dense, including multiple coding fixes and updates, changes to payment provisions, quality updates, and even something for utilization review.
Coders can choose from a variety of anatomic modifiers to report procedures performed on specific toes. Review how to properly apply these modifiers and which codes they cannot be reported with.
CMS recently released its seventh maintenance update for National Coverage Determinations to incorporate ICD-10 and other coding updates, which may require providers to contact Medicare Administrative Contractors regarding previously submitted claims.
CMS’ April I/OCE update includes numerous code and status indicator changes, as well as corrections to its January release. Kimberly Anderwood Hoy Baker, JD, CPC, looks at the changes providers should review to ensure claims including these codes are processed correctly.
Q: Are there any new HCPCS codes for recently released biosimilar products on the horizon? Our physicians and pharmacists are being contacted by the manufacturer about purchasing and using them, but we want to be sure we can report them appropriately.
Obesity is a condition that can complicate coding for other diagnoses in a patient’s record. Lori-Lynne A. Webb, CPC, CCS-P, CCP, CHDA, COBGC, CDIP, writes about how to report BMI and what must be documented in order to link it with other conditions.
Lori-Lynne A. Webb, CPC, CCS-P, CCP, CHDA, COBGC, CDIP, reviews scenarios for initial, subsequent, and sequela encounters, and helps coders better understand how to assign seventh characters for each type of encounter. Note: To access this free article, make sure you first register if you do not have a paid subscription.
The FY 2017 IPPS proposed rule addresses MS-DRG classifications and relative weights pertaining to the categories of other cardiothoracic procedures without MCC, and injuries, poisonings and toxic effects of drugs.
The American Health Information Management Association has officially responded to proposed ICD-10-CM/PCS codes that were presented at the ICD-10 Coordination and Maintenance Committee meeting held in March by CMS.
Kimberly Anderwood Hoy Baker, JD, writes about the many changes in the 2017 IPPS proposed rule, and explains how almost everyone could be affected by CMS’ proposals.
Modifier –GA isn’t the only modifier available to report how services may relate to Medicare coverage policies in hospitals. Learn more about how to properly report modifiers –GX, -GY, and -GZ.
CMS’ coding modifiers are not always used to report clinical components of a service. Sometimes they can be used in a hospital to provide information about how a service relates to Medicare coverage policies.
Which services should clinical documentation improvement (CDI) specialists target in outpatient facilities? Anny Pang Yuen, RHIA, CCS, CCDS, CDIP , writes about how outpatient CDI differs from inpatient CDI and how it can be applied in hospitals or physician practices.
Sepsis isn’t the only clinical condition with an updated definition that could impact coding and documentation. A task force of the National Pressure Ulcer Advisory Panel recently changed terminology related to pressure ulcers that includes new terms that are not yet part of ICD-10-CM.
