Providers are beginning to see some translation of CMS’ National Coverage Determinations (NCD) for ICD-10 with the release of Transmittal R1122OTN and Medlearn Matters Article MM7818 .
The Hospital Outpatient Payment Panel recommended CMS change the supervision requirements for 15 HCPCS and CPT ® codes during its second meeting this year in August. CMS released details of the meeting September 24.
CMS is proposing two major changes as part of the 2013 OPPS proposed rule, released July 6. One has to do with how CMS proposes to calculate APC relative weights; the other addresses the reimbursement level for separately payable drugs and biologicals without pass-through status. Jugna Shah, MPH, and Debbie Mackaman, RHIA, CHCO, discuss the proposed changes for OPPS payment.
Providers will now soon need only one unique health plan identifier when billing insurance companies. CMS finalized the Administrative Simplification: Adoption of Standard for Unique Health Plan Identifier rule released August 24.
Inpatient facilities received mixed news on proposed changes to the list of complications and comorbidities (CC) and major CCs (MCC) in the fiscal year (FY) 2013 Inpatient Prospective Payment System (IPPS) final rule , released August 1.
The National Center for Health Statistics, the Centers for Disease Control and Prevention (CDC), and CMS have posted updated files for ICD-10-CM for 2013.
CMS is proposing two major changes as part of the 2013 Outpatient Prospective Payment System (OPPS) proposed rule , released July 6. One has to do with how CMS proposes to calculate APC relative weights and the other with the reimbursement level for separately payable drugs and biologicals without pass-through status.
CMS reassigned 10 codes to status indicator K (paid under OPPS; separate APC payment) as part of the July update to the Integrated Outpatient Code Editor .
Providers will soon be reimbursed by Medicare for a new, less-invasive aortic valve replacement procedure. Medicare Acting Administrator Marilyn Tavenner announced CMS’ decision to pay for transcatheter aortic valve replacement under specific conditions.
The American Health Information Management Association (AHIMA) continues to advocate for no delay in the implementation date for ICD-10-CM and ICD-10-PCS.
CMS instructed fiscal intermediaries (FI) and Medicare Administrative Contractors (MAC) to hold claims containing CPT ® code 33249 (insertion or replacement of permanent pacing cardioverter-defibrillator system with transvenous lead[s], single or dual chamber) and HCPCS code C1882 (cardioverter-defibrillator, other than single or dual chamber [implantable]).
The January update to the Integrated Outpatient Code editor generally includes a large number of changes and the January 2012 update is no exception. Dave Fee, MBA, highlights the most significant changes including the addition of modifier –PD, which he calls one of the real sleepers in this release.
CMS continues to add more screening services to the list of covered preventative services. The newest additions involve screenings for sexually transmitted infections (STI).
CMS added modifier -PD (diagnostic or related nondiagnostic item or service provided in a wholly owned or wholly operated entity to a patient who is admitted as an inpatient within three days or one day) to the Integrates Outpatient Code Editor (I/OCE) as part of the January updates detailed in Transmittal 2370 .
