Updates by Reed Smith on U.S. legislative & regulatory developments affecting the health care industry
As recently announced, CMS is conducting what it describes as a “limited demonstration” of an internet-based notice and comment mechanism on internally-generated requests to discontinue Level II HCPCS codes. CMS has just released details regarding the first two HCPCS codes it is proposing to remove under this process:
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CMS has announced what it is describing as a “limited demonstration” of an internet-based notice and comment mechanism on requests to discontinue Level II HCPCS codes. The internet-based process would apply to HCPCS discontinuation requests that are generated by CMS based on national program operating needs, and that are not the subject of other…
CMS has announced that it is extending its partial ICD-9-CM and ICD-10 code freeze to reflect enactment of legislation (the Protecting Access to Medicare Act of 2014) that prevents the agency from adopting ICD-10 prior to October 1, 2015. Under the new schedule, on October 1, 2014 there will be only limited code updates…
CMS is holding a public meeting on July 14, 2014 to receive comments on the appropriate basis for establishing payment amounts for new or substantially revised HCPCS codes being considered for Medicare payment under the clinical laboratory fee schedule for 2015. The meeting also provides a forum for those who submitted reconsideration requests regarding…
CMS has announced that it is holding series of meetings in May and June to discuss pending application for the 2015 Healthcare Common Procedure Coding System (HCPCS) update. The dates are as follows:
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CMS has released the 2014 update to the Healthcare Common Procedure Coding System (HCPCS) files, which include the Level II alphanumeric HCPCS procedures and modifiers, long and short descriptions, and applicable Medicare administrative, coverage, and pricing data.
The deadline for applications for new Healthcare Common Procedure Coding System (HCPCS) codes to be considered for the 2015 update is January 3, 2014.
In addition to delaying the CY 2014 Medicare payment update final rules, CMS has announced that the partial government shutdown is expected to impact completion of the CY 2014 HCPCS coding update. CMS intends to publish the 2014 HCPCS Annual Update file by November 27, 2013 (based on the timing of the final rules)…
CMS published a final rule on August 7, 2013 that updates Medicare hospice reimbursement and related policies for FY 2014, which begins on October 1, 2013. The final rule increases Medicare hospice payments by 1.0% compared to FY 2013 rates, but down slightly from the 1.1% increase anticipated in the proposed rule. Specifically, CMS…
On October 1, 2014, the ICD-9 code sets used to report medical diagnoses and inpatient procedures will be replaced by ICD-10 code sets. CMS is hosting a call on August 22, 2013 to discuss the upcoming transition.
CMS has announced that it is hosting a July 10, 2013 public meeting to receive comments and recommendations on the appropriate basis for establishing payment amounts for new or substantially revised HCPCS codes being considered for Medicare payment under the clinical laboratory fee schedule for calendar year 2014. The deadline for registration of presenters…
On May 3, 2013, CMS and the Office of the National Coordinator for Health Information Technology (ONC) are hosting a meeting to discuss electronic health records, the increase in code levels billed for some Medicare services, and appropriate coding in an increasingly-electronic environment. The meeting, which is aimed at providers, health information technology vendors,…
An April 18, 2013 CMS provider call will focus on the transition to the ICD-10 code set, including implementation planning and preparation strategies.
The GAO has issued a report on the methodology CMS uses to calculate a risk adjustment for Medicare Advantage (MA) plans, updating an analysis in provided in January 2012. The GAO previously reported that differences in diagnostic coding between MA plans and Medicare FFS resulted in inaccurately-high MA risk scores and excessive payments to…
In preparation for the October 1, 2014, ICD-10 code set implementation date, CMS has posted a variety of ICD-10 checklists and planning timelines for provider practices, hospitals, and payers. CMS also has outlined suggested steps for ensuring a smooth transition to ICD-10 and preparing for potential cash-flow disruptions from claims processing delays. For instance, CMS…
CMS is holding series of meetings in May and June 2013 to discuss preliminary determinations for applications for new Healthcare Common Procedure Coding System (HCPCS) codes for the 2014 update. The following are the 2013 public meeting dates:
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On March 5, 2013, the ICD-9-CM Coordination and Maintenance Committee is holding a public forum to discuss proposed code changes to the ICD-9-CM and ICD-10-CM/PCS code sets. As previously reported, CMS has scheduled implementation of the ICD-10-CM/ICD-10-PCS code sets for October 1, 2014. Accordingly, only limited code updates to capture new technologies and diseases will…
CMS has posted the final 2013 new and reconsidered clinical laboratory fee schedule test codes, including final payment determinations (crosswalk or gapfill).
CMS has posted the 2013 update to the Healthcare Common Procedure Coding System (HCPCS) files. The files include the Level II alphanumeric HCPCS procedures and modifiers, long and short descriptions, and applicable Medicare administrative, coverage, and pricing data.
CMS recently made it official that it is delaying implementation of the ICD-10-CM/ICD-10-PCS code sets until October 1, 2014. CMS has released two educational articles for providers explaining various implementation issues. The first article, “Updated ICD-10 Implementation Information,” provides an overview of the differences between the ICD-10 and ICD-9 code sets, and discusses provider preparation…
