Coding Resource Center
October 2021
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 […]
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 […]
