CMS recently released an updated MLN fact sheet reminding providers about documentation requirements for requests from its Comprehensive Error Rate Testing (CERT) program.
CMS updated its July 2024 HCPCS Quarterly update file in May with a total of 70 new HCPCS codes, 11 discontinued codes, and 32 revised codes. All code changes will be implemented July 1.
The Food and Drug Administration’s (FDA) emergency use authorization for Pemgarda, a pre-exposure COVID-19 prophylaxis, has led to the release of HCPCS Level II codes for the drug and its administration.
CMS published a summary of its first quarter 2024 HCPCS Level II code update application decisions. There were 48 additions, two code definition revisions, and seven discontinuations.
CMS proposed hundreds of ICD-10-CM code changes in the 2025 IPPS proposed rule, published April 10, including 252 new codes, 13 revised codes, 36 invalidated codes.
CMS published its HCPCS Quarterly Update in March, which heralded the sum of 94 HCPCS Level II code additions, discontinuations, and definition revisions. The changes became effective April 1.
The Journal of the American Medical Association (JAMA) published a study in March found that “foot and ankle care was associated with an 11% lower likelihood of death…and a 9% lower likelihood of major amputation (above or below knee).”
CMS retroactively added two new CPT codes for respiratory syncytial virus (RSV) vaccine administration. The codes affect services rendered on or after October 6, 2023.
A JAMA study published in January found that patients with the highest risk for severe COVID-19 infection received outpatient therapy less often than those with the least risk.
CMS published a summary of its fourth quarter 2023 HCPCS Level II code update application decisions, including 36 additions, four revisions, and 18 deletions.
CMS posted its 2024 Therapy Code List and Dispositions on December 28. This list indicates whether therapy services, as distinguished by HCPCS Level II and CPT codes, are recognized under CMS as “sometimes therapy” or “always therapy.”
Michael Lonski, Ph.D., a licensed psychologist, was sentenced to 27 months of imprisonment and three years of supervised release for conducting $2.6 million in Medicare and Medicaid fraud, the Department of Justice announced December 19.
CMS released its January 2024 HCPCS Level II code update December 7, outlining 344 new and 74 discontinued codes. The code changes will become effective January 1, 2024.
A recent Office of Inspector General audit of inpatient and outpatient Medicare claims estimated that nearly 20% of cases including codes for abuse or neglect were not reported to law enforcement.
CMS recently published a summary of its third quarter 2023 HCPCS Level II code update application decisions, accepting 51 of 61 submissions. There were also 10 codes that will be discontinued and one code whose definition will be revised. The additional codes mostly consist of injections and skin substitutes.
CMS estimated $4.4 billion in improper payments in 2022 for hospital outpatient services, according to a Comprehensive Error Rate Test review recently published in the Medicare Provider Compliance Newsletter. According to the report, of the 1,899 inspected claims, 5.4% were improperly paid.
CMS' recently implemented October OPPS update brings with it a slew of new, revised, and deleted CPT and HCPCS Level II codes with effective dates ranging from April 18 to October 1. Among the additions are codes for vaccines, vaccine administration, skin substitutes, renal histotripsy, and breast imaging.
AMA published the 2024 CPT code set with 349 total editorial changes, including 230 additions, 49 deletions, and 70 revisions. The press release announced revisions for immunization/administration sections, E/M clarification, and new Spanish procedure descriptions.
