Coding Resource Center
December 2024
The Centers for Medicare and Medicaid Services (CMS) announced it is implementing 50 new procedure codes into the International Classification of Diseases, Tenth Revision, Procedure Coding System (ICD-10-PCS), effective April 1, 2025. The Code Tables, Index and related Addenda files for the new 50 procedures are available on the CMS website under ICD-10. The International […]
A report issued by the Office of Inspector General (OIG) revealed providers did not always comply with Federal requirements when billing for surgical services, particularly co-surgery and assistant-at-surgery services. Under Medicare Part B, The Centers for Medicare and Medicaid Services (CMS) makes a reduction in payment for physicians who work together as co-surgeons during a […]
November 2024
On November 1, 2024, the Centers for Medicare and Medicaid Services (CMS) issued the final rule for the Medicare Physician Fee Schedule (MFPS) for calendar year (CY) 2025. This final rule covers 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 November 1, 2024, the Centers for Medicare and Medicaid Services (CMS) issued the final rule for the Medicare Hospital Outpatient Prospective Payment System (HOPPS) and Ambulatory Surgery Center (ASC) Prospective Payment System for calendar year (CY) 2025. This final rule covers outpatient hospital and ASC services furnished to beneficiaries on or after January 1, […]
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 […]
