After years of delays, industry and legislative pushback, and millions spent on technology upgrades and education, ICD-10 is finally here. Even though the fundamental process of coding and billing claims has not changed, providers will still need to pay close attention to their processes to keep the revenue cycle going and reduce denials.
Providers know the drill for addressing and operationalizing CMS' annual IPPS and OPPS updates, along with the usual ICD-9-CM and CPT® coding changes. The industry has become used to CMS' timetable for releasing inpatient and outpatient proposed and final rules and knows that it has to be ready to go live with coding, billing, and operational changes October 1 and January 1, respectively.
Most short-term acute-care inpatient hospital stays covered under Medicare Part A are payable under the IPPS, based upon the MS-DRG to which that case is assigned. Each FY, CMS publishes a final rule setting out the IPPS changes for that FY. The IPPS changes for FY 2016 can be found in more detail in the source authorities cited at the end of this note.
This week’s updates include the beginning of Medicare Open Enrollment; January 2016 quarterly update for the DME, Prosthetics, Orthotics and Supplies (DMEPOS) Competitive Bidding Program (CBP); and more!
