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.
CMS would use the proposed modifiers to implement a 15% payment reduction starting in 2022 for services provided in whole or in part by physical therapy assistants (PTA) and occupational therapy assistants (OTA).
CMS recently released new documentation guidance on medical review of E/M services performed by medical students. A medical student may document E/M services if the physician performs or re-performs the exam and then verifies the student’s documentation.
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.
Integrating facility and professional fee coding into one centralized department model can help organizations make the most of advances in technology and manage costs.
Payers rely heavily on the use of data and data analytics to manage their risk. Follow these tips for using payer guidelines to understand what they’re looking for and how to improve documentation.
