Sepsis isn’t the only clinical condition with an updated definition that could impact coding and documentation. A task force of the National Pressure Ulcer Advisory Panel (NPUAP) recently changed terminology related to pressure ulcers that includes new terms that are not yet part of ICD-10-CM.
CMS recently released its seventh maintenance update for National Coverage Determinations to incorporate ICD-10 and other coding updates, which may require providers to contact Medicare Administrative Contractors regarding previously submitted claims.
On April 29, CMS releaseda transmittal and MLN Matters articleregarding use of JW modifier for drug wastage. The transmittal states that, effective July 1, claims for discarded drug or biological amounts not administered to any patient, shall be submitted using the JW modifier. Also, effective July 1, providers must document the discarded drugs or biologicals in patient's medical record.
The addition of thousands of new diagnosis and procedure codes in a single year might typically be cause for concern for hospitals, with ICD-9-CM updates before the 2012 code freeze rarely topping more than a couple hundred per year.
Few in the healthcare industry would argue that the way the government currently pays for drugs is the most cost-effective, efficient, and equitable method possible.
Last year, as ICD-10 implementation approached, organizations throughout the U.S. reported varying levels of comfort with regard to readiness and understanding of the impact of ICD-10 on physician workflow. For some, it was business as usual. For other physicians, ICD-10 became one more check box on the list of reasons to leave practice.
CMS issued the fiscal year (FY) 2017 IPPS proposed rule Monday with updates to several MS-DRG classifications and relative weights. The amount of proposed MS-DRG changes, said Shannon McCall, RHIA, CCS, CCS-P, CPC, CPC-I, CEMC, CCDS, director of HIM and coding for HCPro, a division of BLR, in Danvers, Massachusetts, was expected due to the transition to IDC-10.
There are new enforcement editing requirements regarding the coverage and billing of Partial Hospitalization Program services, likely due to significant problems with these claims and coding highlighted in the 2016 proposed and final OPPS rules.
