Along with quality measure removals in the 2018 OPPS and MPFS final rules, CMS has continued to propose additional removals in the 2019 proposed rules. In addition, the agency is proposing to add to its ability to remove quality measures in the future.
It’s been one year since the National Association of Healthcare Revenue Integrity welcomed its first member and we are now more than 700 members strong. That’s more than 700 driven, dedicated individuals from across the country who have joined forces to ensure the revenue integrity profession is recognized for its unique contributions to the healthcare field.
In the 2019 OPPS proposed rule, CMS does not introduce a new skin substitute payment policy but is seeking comment on potential changes for future rulemaking.
The National Center for Health Statistics recently released the 2019 ICD-10-CM Official Guidelines for Coding and Reporting, effective October 1, which include updated language and added specificity for classifying diagnoses.
CMS did not propose any new comprehensive APCs (C-APC) last year, taking a rare year off, but it did introduced three new C-APCs in the 2019 OPPS proposed rule, released in late July.
CMS’ 2019 OPPS proposed rule continues the agency’s efforts to enforce site-neutral payments and reduce drug payments by introducing policies to reduce reimbursement for hospital outpatient clinic visits at off-campus, provider-based departments (PBD) and expanding last year’s payment reductions for drugs purchased under the 340B discount pricing program by nonexcepted PBDs.
Many HIM directors find that managing the coding team requires a different type of focus than other functions within the department. This may be true because coding professionals have advanced education, prefer a quiet work environment, and require less direction.
The fiscal year (FY) 2019 ICD-10-CM code update, released on June 11, includes 279 code additions, 143 revisions, and 51 invalidations. The number of changes is significantly less than the past two years, which makes me think we are getting back to the “norm” of expected yearly changes.
In the April 2018 OPPS update transmittal, CMS announced new HCPCS code C9749 (repair of nasal vestibular lateral wall stenosis with implant[s]), effective April 1, 2018.
