CMS decided not to cap outpatient payment rates for cardiac resynchronization therapy defibrillator procedures at the standardized inpatient rate as part of the calendar year 2012 Outpatient Prospective Payment System final rule. In addition, CMS finalized several changes regarding payments for 11 cancer centers, drug payment calculations, and physician supervision. Jugna Shah, MPH, and Kimberly Anderwood Hoy, JD, CPC, explain the changes facilities will see in 2012.

Coders should already be familiar with the 285 new, revised, and deleted ICD-9-CM codes that CMS finalized for fiscal year (FY) 2012. However, it’s critical that providers also examine how these changes directly affect MS-DRG assignment. Robert Gold, MD, examines a number of these changes, including MS-DRG assignment related to cardiac-specific comorbidities, autologous bone marrow transplants, excisional debridement, and thoracic aneurysm repair.

By now, you're probably familiar with Medicare hospital-acquired conditions (HAC) and know that they are high cost, high volume, or both.

CMS’ Office of E-Health Standards and Services (OESS) won’t enforce compliance with the HIPAA 5010 transaction set until March 31, 2012, the agency announced November 17 . The 90-day delay will not...

CMS created the following four podcasts based on the January 12 national provider call, “Preparing for ICD-10 Implementation in 2011:” Welcome and ICD-10 Overview Implementation Strategies for 2011...

CMS recently posted the 2012 ICD-10-PCS codes and coding guidelines . A summary of the major changes for 2012 states that there are 1,182 new codes, 381 revised titles, and 1,345 deleted codes. In...

As many of you know, before we switch to ICD-10-CM/PCS, we first will be transitioning to HIPAA Version 5010. In fact, that date is less than one year away. By January 1, 2012, providers need to be...

CMS included nine topics related to ICD-10-CM/PCS on its tentative agenda for the ICD-9-CM Coordination and Maintenance Committee meeting March 9-10. This is the final meeting to address ICD-9-CM and...

You can expect ICD-10 updates to follow the same timeline that you are already accustomed to for ICD-9—almost. An ICD-9-CM Coordination and Maintenance Committee Meeting was held September 15-16,...

CMS will hold a Special Forum to receive input on the development and implementation of its hospital value-based purchasing program, as required by Section 3001 of the Affordable Care Act. The...

During the ICD-9-CM Coordination & Maintenance Committee Meeting on Sept. 15, CMS representative Pat Brooks, RHIA, announced that the committee had finalized the decision to implement a partial...

On June 23, CMS issued MLN Matters Special Edition article #SE1019 , which is intended to provide healthcare entities more information about the implementation of ICD-10-CM and ICD-10-PCS. In...

After having to cancel in February, CMS rescheduled its fourth national provider call for March 24 regarding the implementation of HIPAA Version 5010. The transition to this new billing transaction...

Late Wednesday night, CMS announced that due to inclement weather, it was canceling the national provider conference call on HIPAA 5010, New Error Handling Transactions, which was scheduled to take...

I was poking around the CMS Web site today, in the ICD-10 section of course, and I noticed a brand new page devoted to the ICD-10 MS-DRG Conversion Project . While I've heard different CMS...

CMS recently posted on its Web site a presentation titled "Introduction to ICD-10-CM/PCS: For Physician Specialty Group Representatives." In addition to CMS representative Pat Brooks, a number of...