The January quarterly I/OCE update includes new modifiers, changes related to expanded packaging, and continued refinement of CMS' skin substitutes categories, but the biggest change for outpatient hospitals is the implementation of comprehensive APCs (C-APC).
Editor's note: With the increased specificity required for ICD-10-CM coding, coders need a solid foundation in anatomy and physiology. To help coders prepare for the upcoming transition, we will provide occasional articles about specific anatomical locations and body parts as part of a larger series for ICD-10-CM preparation. This month's article addresses the anatomy of the urinary system.
The implementation of Comprehensive APCs (C-APCs) in the 2015 OPPS final rule likely wasn't a huge surprise to most providers, given CMS discussed this concept in the 2014 final rule and indicated it expected to implement it the following year.
CMS designates certain procedures as inpatient-only and identifies them using CPT codes. Hospitals normally only use CPT codes for outpatient coding, so this may be confusing for coders who use ICD-9-CM Volume 3 codes for inpatient procedures. Coders need to know which procedures are on the inpatient-only list to monitor compliance with this rule as they apply inpatient procedure codes.
The ICD-10 delay forced many healthcare organizations to rethink their ICD-10 staffing and implementation plans. Baptist Health System in Birmingham, Alabama, devised a plan to prepare for the one-year delay of ICD-10 by revising its budget and relying on new graduates to fill coder positions.
