Tag: IPPS Rule

medical necessity errors

Top Error Rates Offer Clues to Denials

The Comprehensive Error Rate Testing (CERT) program grew out of the Department of Health and Human Services Office of Inspector General improper payment rate estimates from 1996 through 2002. Due to sample size restrictions, the Centers for Medicare & Medicaid Services (CMS) assumed responsibility because they had access to more granulated data in 2003. The […]
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2021 Inpatient Prospective Payment System Rule

CMS Releases Long-Awaited 2021 FY IPPS Final Rule

  Medicare spending on acute-care inpatient hospital services will increase by about $3.5 billion in FY 2021 As the healthcare industry continues to be buffeted by the unrelenting coronavirus pandemic, the Centers for Medicare & Medicaid Services (CMS) has released the Inpatient Prospective Payment System (IPPS) and the Long-Term Care Hospital (LTCH) final rule. The […]
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ICD-10-CM-PCS Code Change

FY 2021 IPPS Proposed Rule Includes 600 Potential Code Changes

The entire list of proposed changes to ICD-10-CM/PCS codes is available in tables 6A-6K and 6P.1a-6P.4a of the rule. CMS released the fiscal year (FY) 2020 Inpatient Prospective Payment System (IPPS) proposed rule May 11, which includes just shy of 600 ICD-10-CM code changes. Proposed changes include 490 code additions, 47 revisions, and 58 invalidations, slated to […]
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Medical Coding Services

CMS To Revamp Coding For New Medical Technology

Dive Brief CMS Administrator Seema Verma announced Thursday the agency will overhaul coding regulations that she argues have hindered beneficiary access to new medical technology. Medical device companies will now be able to apply for a new permanent Healthcare Common Procedure Coding System (HCPCS) code twice a year, instead of annually. CMS also recently eliminated […]
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