Coding Resource Center
January 2023
On January 11, 2023, 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 23, 2020, October 2, 2020, January 7, 2021, April […]
On January 30, 2023, it was announced that both national emergencies for addressing COVID-19 will end on May 11, 2022, nearly three years after the United States imposed measures to curb the spread of the illness. After repeatedly ensuring at least a 60-day notice of the end of the PHE, the current announcement meets that […]
The Office of the Inspector General (OIG) performed an audit which revealed improper Medicare payments for co-surgeon and assistant-at-surgery services when Part B providers billed these services without the appropriate payment modifiers. The OIG reviewed a randomly selected sample of 100 services rendered by Part B providers between 2017 and 2019 that were billed without […]
The Department of Health and Human Services (HHS) issued an advisory to alert the U.S. healthcare section of new cyberattack threats, specifically the Royal and BlackCat groups that have recently attacked U.S. electronic medical record and practice management software providers using ransomware. Ransomware is a type of malicious software designed to infect computers and servers […]
November 2022
The Centers for Medicare and Medicaid Services (CMS) issued the final rule for the MPFS and HOPPS/ASC These final rules cover physician and hospital outpatient/ambulatory surgery services furnished to beneficiaries on or after January 1, 2023. Highlights are described below: For MFPS: The finalized conversion factor (CF) is $33.0607, which reflects the CY 2022 CF […]
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, 2023. Highlights are described below: The finalized base rate for the ESRD PPS is $265.57, which […]
October 2022
On October 5, the Centers for Medicare and Medicaid Services (CMS) released a Request for Information (RFI) to ask for public comment on the creation of a “National Directory of Health Care Providers and Services” (NDH). CMS seeks comment on how a single centralized directory using modern technology could reduce maintenance burden on providers and […]
On October 13, 2022, 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 23, 2020, October 2, 2020, January 7, 2021, April […]
Financial incentives to encourage home dialysis may be failing to produce its intended effect, according to a first-year analysis of Medicare’s End-Stage Renal Disease (ESRD) Treatment Choices (ETC) Model. This model is a multi-year, mandatory participation program created and implemented by U.S. Center for Medicare & Medicaid Innovation A random clinical trial was conducted, which […]
On September 28, 2022, the United States District Court for the District of Columbia annulled the differential payment rates for 340B-acquired drugs as outlined in the 2022 Outpatient Prospective Payment Final Rule. The ruling states the Centers for Medicare and Medicaid Services (CMS) cannot apply the average sales prices (ASP) minus 22.5 percent drug payment […]
