Coding Resource Center
April 2024
On April 10, 2024, the Centers for Medicare & Medicaid Services (CMS) issued their proposed rule that updates Medicare payment policies for hospitals under the Inpatient Prospective Payment System (IPPS) for fiscal year (FY) 2025. Once these polices become final, they will cover inpatient hospital discharges on or after October 1, 2024. Highlights are described […]
According to First Coast Service Options, Inc., the Medicare Administrative Contractor (MAC) for Florida, Puerto Rico and the U.S. Virgin Islands, has been receiving a flood of appeals requests for denials of HCPCS code G2211 when billed with an office and outpatient (O/O) E/M service (CPT® codes 99202-99205 and 99211-99215) appended with modifier 25 because […]
The Department of Health and Human Services (HHS) issued new guidance to the nation’s teaching hospitals and medical schools regarding Hospital Interpretive Guidelines for Informed Consent. Specifically, requiring written informed patient consent for breast, pelvic, prostate and rectal exams – especially if the patient is anesthetized – for educational and training purposes performed by medical […]
March 2024
On March 9, 2024, the President signed the Consolidation Appropriations Act, 2024 (H.R. 4366) into law. This $460 billion “minibus” package of six spending bills prevented a partial government shutdown by providing funding for fiscal year (FY) 2024 (through September 30, 2024). From a healthcare perspective, subtitle C – Medicare, contains measures which include: The […]
On February 21, 2024, Change Healthcare, a subsidiary of UnitedHealth Group (UHG), suffered what is now called the “most significant cyber-attack on the U.S. health care system in American history” at the hands of the Blackcat ransomware group. What makes this ransomware attack unprecedented is Change Healthcare’s role in the health care system – it […]
The issues surrounding patient misidentification include threats to patient safety, patient privacy, and a catalyst for unnecessary costs to patients and providers. Federal regulators and the healthcare industry have pushed for the creation of a unique patient identifier (UPI) that would give each patient an individual code, like a social security number, to match that […]
The U.S. Department of Health and Human Services Office of the Inspector General (HHS-OIG) now has an Instagram profile (IOGatHHS). Users can now follow this agency to obtain the latest news on their oversight of the HHS department’s programs, including Medicare and Medicaid.
February 2024
W.L. Gore & Associates announced FDA approval of a lower profile GORE® VIABAHN® VBX Balloon Expandable Endoprosthesis (VBX Stent Graft). This lower profile stent graft was designed in response to the need for smaller delivery systems; and is still used in the treatment of complex vascular disease. According to Gore, the VBX stent graft now […]
The Center for Medicare and Medicaid Services (CMS) and National Center for Health Statistics (NCHS) have announced the ICD-10-CM and ICD-10-PCS updates which are effective April 1, 2024. There are two annual updates for ICD-10, October and April. October updates are typically more extensive than the April updates. For ICD-10-CM, there are no new diagnosis […]
As part of the April 1, 2023, implementation date for ICD-10 codes (both diagnosis and procedure code changes), the Centers for Medicare and Medicaid Services (CMS) updated the Medicare Severity Diagnosis-Related Group (MS-DRG) software package to accommodate the 41 new procedure codes. Version 41.1 of the MS_DRG Classifications and Software is effective for discharges on […]
