Archive for May 2021

ICD-11 introduces some great new features, including post-coordinated codes. Though you may not use these terms, we’re all familiar with pre-coordinated codes since all of the codes in the code sets we use today (including ICD-10-CM, ICD-10-PCS and CPT for example) are pre-coordinated. Pre-coordinated codes contain the pertinent information about a clinical concept in a…

Effective August 11, 2020, the Centers for Medicare & Medicaid Services resumed the Comprehensive Error Rate Testing program activities that were temporarily suspended in response to the public health emergency for the 2019-Novel Coronavirus (COVID-19) pandemic. CMS uses Comprehensive Error Rate Testing to verify Medicare Administrator Contractors are properly paying claims. CERT audits coding and…

On April 27th CMS released the 2022 Inpatient Prospective Payment System (IPPS) proposed rule.[1] One of the most significant changes proposed for the V39 MS-DRG grouper logic includes changes to the severity level designation for unspecified codes. Recall for FY 2020, CMS proposed changes to the severity designation for 1,492 ICD-10-CM diagnosis codes which was…

On April 27th CMS released the FY 2022 Inpatient Prospective Payment System (IPPS) proposed rule.[1] The proposal describes 127 new ICD-10-PCS codes, with a majority of the changes in the Surgery section. The Table below presents an outline of proposed changes to the surgery section by body system. In addition to the 79 new codes…

On April 27th CMS released the FY 2022 Inpatient Prospective Payment System (IPPS) proposed rule.[1] The Table below provides an outline of 153 proposed new ICD-10-CM codes, distributed across several chapters. Notable highlights for the proposed ICD-10-CM changes include new codes for: Immune effector cell associated neurotoxicity syndrome (ICANS) in category G92. ICANS is a clinical…