CMS changed the status indicator for CPT code 99497 (advance care planning including the explanation and discussion of advance directives such as standard forms [with completion of such forms, when performed], by the physician or other qualified health care professional; first 30 minutes, face-to-face with the patient, family member, and/or surrogate) from N (no additional payment, payment included in line items with APCs for incidental service) to Q1 in the 2016 OPPS final rule.
With the latest edition of the NCCI Manual, effective January 1, CMS does not introduce any new guidance for recurring coding trouble areas including modifier -59 (distinct procedural service) usage and injection and infusion services, but some new clarifications could aid coding departments.
This week’s updates include the January 2016 update of the hospital OPPS; April 2016 quarterly update for the DME, Prosthetics, Orthotics and Supplies (DMEPOS) Competitive Bidding Program (CBP); and more!
CMS did not change the logic for comprehensive APCs (C-APC) or complexity adjustments in the 2016 OPPS final rule, but did add 10 new C-APCs for 2016 in addition to the 25 established for the first time for 2015.
I first attended a lecture on the "upcoming" ICD-10 changes that were expected in 1991 (when the rest of the world started transitioning). On October 1, 2015, a mere 24 years and countless lectures later, the U.S. finally adopted ICD-10 (via ICD-10-CM and PCS, which are both unique to the U.S. at this time).
