Coding Resource Center
October 2024
On September 30, 2024, the Centers for Medicare and Medicaid Services (CMS) issued an Interim final action with comment period (CMS-1818-IFC) for fiscal year (FY) 2025 Inpatient Prospective Payment System (IPPS) rates. Specifically, this document outlines changes to the Medicare wage index values and establishment of a traditional payment exception for low wage hospitals substantially […]
September 2024
The American Medical Association (AMA) released the 2025 CPT® code set on September 9, 2024. The development of new technologies and innovative procedures prompted most of the annual changes. Key updates include: A total of 11,321 codes are available for 2025. 420 editorial changes were made for the 2025 code set, including 270 new codes, […]
In a press release issued by the Centers for Medicare & Medicaid Services (CMS), Wisconsin Physicians Service Insurance Corporation (WPS), the Medicare Administrative Contractor (MAC) for Iowa, Kansas, Missouri, Nebraska, Indiana, and Michigan was involved in a data breach that exposed patients’ protected health information (PHI) involving MOVEit software, a third-party application used by WPS […]
The Centers for Medicare and Medicaid Services (CMS) issued a recent request for information (RFI) concerning the potential jurisdiction consolidation of 4 Medicare administrative Contractor (MAC) jurisdictions into 2 jurisdictions, and potential extension of MAC contracts to 10 years: According to CMS, the purpose of this RFI is to assist in identifying the benefits and […]
August 2024
On August 1, 2024, the Centers for Medicare & Medicaid Services (CMS) issued their final rule that updates Medicare payment policies for hospitals under the Inpatient Prospective Payment System (IPPS) for fiscal year (FY) 2025. These finalized policies will cover inpatient hospital discharges on or after October 1, 2024. Highlights are described below: The complete […]
Electronic Health Record (EHR) vendor Epic Systems announced that patients will be able to download their medical information to smartphone apps of their choice, giving them more control over their medical information. Patient access to digital medical information already exists through application programming interfaces (API), and Epic currently allows patients to access their own medical […]
July 2024
The ICD-10 Procedural Coding System (ICD-10-PCS) codes and updates for fiscal year (FY) 2024 have been released, and are available on the 2025 IC-10-PCS Home Page of the CMS website. These codes are to be used for discharges occurring from October 1, 2024, through September 30, 2025. The update files include official coding and reporting […]
On July 10, 2024, the Centers for Medicare and Medicaid Services (CMS) issued the proposed rule for the Medicare Physician Fee Schedule (MFPS) for calendar year (CY) 2025. These proposed rules cover physician services furnished to beneficiaries on or after January 1, 2025. Highlights are described below: The complete MPFS proposed rule summary can be found […]
On July 10, 2024, the Centers for Medicare and Medicaid Services (CMS) issued the proposed rule for the Medicare Hospital Outpatient Prospective Payment System (HOPPS) and Ambulatory Surgery Center (ASC) Prospective Payment System for calendar year (CY) 2025. These proposed rules cover outpatient hospital and ASC services furnished to beneficiaries on or after January 1, […]
June 2024
The National Coverage Determination (NCD) Dashboard is now available on the Centers for Medicare and Medicaid Services (CMS) website under the Medicare Coverage Determination Process. This document consists of three alphabetized lists: Currently, there are 8 topics on the NCD wait list, 2 topics on the open NCD list and 4 NCDs finalized in the […]
