There were several coding stories you may have missed in June.
Read on to see what you missed.
CMS Releases New Inpatient and Outpatient Procedure Codes
Over the last few months CMS has been releasing procedure codes for your revenue cycle teams, both for inpatients and outpatients.
For your inpatient procedures, the updated ICD-10-PCS codes will available for discharges starting October 1. When it comes to outpatient reporting, most of the HCPCS code changes were just implemented July 1.
Nearly 400 New Diagnosis Codes Coming This Fall, CMS Announces
CMS recently announced the addition of 395 new diagnosis codes, 25 deletions to the diagnosis code set, and 13 revisions. An ample amount of these changes pertains to reporting certain diseases, accidents and injuries, and social determinants of health. These code updates will take effect on October 1.
Medicare Advantage Overpayments Could Eclipse $75B in 2023
MedPAC estimated that Medicare Advantage (MA) plans would be overpaid by $27 billion in 2023, mostly due to coding intensity of enrollee health conditions combined with bonus payments related to quality. That estimation did not factor in favorable selection of MA plans.
Henry Ford Health Taps Into AI to Improve Medical Coding
Detroit-based Henry Ford Health recently expanded its collaboration with CodaMetrix to include patient bedside visits, where abstraction takes an average of 40 minutes per patient and accounts for 20% of the health system's overall coding costs.
Medicare Overpaid $22.5M for Incorrect Place-of-Service Codes
Medicare overpaid $22.5 million in 2019 and 2020 for physician services while enrollees were hospital inpatients or in skilled nursing facilities, according to an audit by OIG.
Researchers conducted analysis of the 2.1 million physician service claim lines identified at risk of overpayment because of non-compliance with the place-of-service policy.
Medicare pays for physician services separately from the payments it makes to inpatient facilities like skilled nursing facilities and hospitals. However, practitioners may not always correctly report the place-of-service code on a claim line, causing Medicare to pay more at higher nonfacility rates than at lower facility rates while beneficiaries were inpatients of facilities, OIG stated.
Amanda Norris is the Director of Content for HealthLeaders.