Coding Resource Center
December 2021
The American Hospital Association (AHA) and the American Medical Association (AMA), among others representing hospitals, health systems and physicians filed suit over the implementation of the No Surprises Act rule. In comments submitted on the interim final rule, the AHA strongly urged federal regulators to restore the independence of the independent dispute resolution process in […]
November 2021
The Centers for Medicare and Medicaid Services (CMS) issued the final rule for the Medicare Physician Fee Schedule (MPFS) and Hospital Outpatient Prospective Payment System (HOPPS)/Ambulatory Surgery Center (ASC). These final rules cover physician and hospital outpatient/ambulatory surgery services furnished to beneficiaries on or after January 1, 2022. Highlights are described below: For MFPS: The […]
A white paper on ICD-11 from the International Federation of Health Information Management Associations (IFHIMA), a non-governmental organization (NGO) in an official connection with the World Health Organization (WHO), was issued. This document includes case studies and guidance for HIM professionals and recommends their participation in relevant committees, task forces and workgroups. The report and […]
October 2021
The place of service (POS) codes provide the necessary setting information in order for claims to be paid correctly. Effective January 1, 2022, the following new POS code and revised POS code will be implemented as part of the professional claim adjudication process: POS 02: Telehealth Provided Other than in Patient’s Home Revised descriptor: The […]
On September 30, 2021, the Centers for Medicare and Medicaid Services (CMS) issued an interim final rule (IFR) to address large out-of-pocket costs to consumers from “surprise billing.” This IFR is the second set of rulemaking from the current Administration that implements the No Surprises Act, signed into law December 2020. The overall intent of […]
On October 16, 2021, Xavier Becerra, Secretary of Health and Human Services (HHS) announced the renewal of the public health emergency (PHE) declared due to the Coronavirus Disease 2019 (COVID-19). The PHE was originally declared on January 31, 2020. Extensions occurred on April 21, 2020; July 25, 2020; October 23, 2020; January 7, 2021; April 15, 2021; and July […]
The Centers for Medicare and Medicaid Services (CMS) issued the final rule for the Medicare End Stage Renal Disease (ESRD) Prospective Payment System (PPS). This final rule covers renal dialysis services furnished to beneficiaries on or after January 1, 2022. Highlights are described below: The finalized base rate for the ESRD PPS is $257.90, which […]
September 2021
On September 7, the American Medical Association (AMA) released the 2022 Current Procedural Terminology (CPT®) code set after approval from the CPT® Editorial Panel. There are 405 editorial changes to CPT® including 249 new codes, 93 revisions and 63 deleted codes. All code changes are effective January 1, 2022: https://www.ama-assn.org/press-center/press-releases/ama-releases-2022-cpt-code-set. Nearly half of changes involve […]
September 2021
On September 14, a meeting of the ICD-10 Coordination and Maintenance Committee Meeting was held, in which the finalized agenda for the updates related to ICD-10-CM/PCS was published. Included in the agenda are details of the addition of ICD-10-CM/PCS code releases effective April 1 of each year in addition to the existing October 1 update. […]
August 2021
On August 2, 2021, the Centers for Medicare & Medicaid Services (CMS) issued a final rule that updates Medicare payment policies for hospitals under the Inpatient Prospective Payment System (IPPS) for fiscal year (FY) 2022. These rules cover inpatient hospital discharges on or after October 1, 2021. Highlights are described below: CMS is finalizing to […]
