Coding Resource Center
July 2021
The FY 2022 ICD-10-CM Official Guidelines for Coding and Reporting have been released by the Centers for Disease Control and Prevention (CDC) and are available on the CDC ICD-10-CM Home Page. These guidelines accompany and complement the official conventions and instructions provided within the ICD-10-CM classification; and are effective on or after October 1, 2021 through September 20, 2022. There […]
On July 19, 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; and renewed on April 21, 2020, July 25, 2020, October 23, 2020, January 7, 2021 and April […]
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. These proposed rules cover outpatient hospital and ASC services furnished to beneficiaries on or after January 1, 2022. Highlights are described below. For Outpatient Hospital: CMS […]
The Centers for Medicare and Medicaid Services (CMS) issued the final rule for the Medicare Physician Fee Schedule (MFPS). These proposed rules cover physician services furnished to beneficiaries on or after January 1, 2022. Highlights are described below: CMS proposed Conversion Factor (CF) of $33.5848, which includes reversal of the 3.75 percent increase signed into law […]
The Centers for Medicare and Medicaid Services (CMS) issued the proposed rule for the Medicare End Stage Renal Disease (ESRD) Prospective Payment System (PPS). These proposed rules cover renal dialysis services furnished to beneficiaries on or after January 1, 2022. Highlights are described below: Proposed base rate for the ESRD PPS is $255.55, which applies […]
June 2021
From a reimbursement perspective, the amount Medicare pays physician providers under Part B is based on the location of the service or procedure is provided, such as a physician’s office, hospital or skilled nursing facility (SNF). This payment is designated as a nonfacility rate and a facility rate. The nonfacility rate is reimbursed at a […]
The American Medical Association (AMA), American College of Radiology (ACR) and the American Osteopathic Association (AOA) are opposing the rebranding of physician assistants as “physician associates”. This response comes as a result of the passage of a resolution by the American Academy of Physician Assistants (AAPA) House of Delegates, officially changing the designation to “physician […]
The FY 2022 ICD-10-CM diagnosis codes have been released by the Centers for Disease Control and Prevention (CDC) and are available on the CDC ICD-10-CM Home Page. Still pending are the 2022 Official Coding and Reporting Guidelines, which were not included with the new codes; as well as the FY 2022 Final Rule for Inpatient Prospective Payment System (IPPS) which is […]
The ICD-10 Procedural Coding System (ICD-10-PCS) codes and updates for FY 2022 have been released, and are available on the 2022 ICD-10-PCS page of the CMS website. These codes are to be used for discharges occurring from October 1, 2021 through September 30, 2022. The update files include official coding and reporting guidelines, code tables, […]
May 2021
The price transparency rule, which went into effect January 1, 2021, requires hospitals to publish a machine-readable filed that outlines their payer-negotiated payment rates. Also required as part of the rule, hospitals must provide a tool that allows consumers to search and view the prices of 300 shoppable medical services. The Centers for Medicare and […]
