In this week’s RA/HCC discussion, we are looking at a few of the HCC modification changes. As previously discussed, the HCC changes are extensive and the information provided below are just a few examples of these V28 changes. Neoplasm Disease Group Liver Disease Group Blood Disease Group Cognitive Disease Group Substance Use Disorder Disease Group… Read More »Bi-Weekly RA/HCC V28 Changes Discussion
To round up our other ICD-10 update guides, the team has pulled together a guide for the DRG updates for 2024. In this guide you’ll find:
Comparing Codes Across ICD Versions: Heart Failure In this month’s ICD-11 deep dive, UASI’s Mary Stanfill continues to examine the differences between ICD-10 and ICD-11 to get a feel for how these changes will impact day-to-day coding. The WHO ICD-11 classification is very different from the 10th version that the United States modified to create… Read More »ICD-11 Monthly – October 2023
Unlike 2023 with no new MS-DRG, the FY2024 changes include 15 new MS-DRGs, found in MDCs 04, 05 and 06. These MS-DRGs include: Notable items in these new MS-DRGs include: The FY2024 IPPS final rule home page can be found at: FY 2024 IPPS Final Rule Home Page | CMS
Let’s continue the discussion surrounding the RA/HCC V28 changes which are effective January 1, 2024. First, a reminder that the underlying concept of RA/HCCs does not change with the 2024 update. CMS’s risk adjustment model is designed to properly recognize each patient’s disease burden and estimate future health care cost for beneficiaries. In this prospective… Read More »Continued Discussion Surrounding RA/HCC V28 Changes
The UASI team has pulled together ICD-10-PCS updates for 2024. These are in addition to the ICD-10-CM updates posted earlier this month. In this guide you’ll find:
While the overall concepts of Risk Adjustment (RA) remain the same, January 1, 2024 will bring significant changes to RA and Hierarchical Condition Categories (HCCs). Currently, Medicare Advantage (MA) plans use version 24 (V24) of HCCs, which was released in 2020. Beginning in 2024, a 3-year phased introduction of version 28 (V28) will begin. The… Read More »Changes Coming to Risk Adjustment & Hierarchical Categories
It’s that time of year again. Below you will find a guide for the 2024 ICD-10-CM updates. Topics covered are:
Comparing Codes Across ICD Versions: Pneumonia, present on admission By: Mary H. Stanfill, MBI, ACHIP, RHIA, CCS, CCS-P, FAHIMA As the US has started exploring ICD-11 adoption, UASI is dedicated to looking for ways to make it’s adoption less intimidating. The WHO ICD-11 classification is very different from the 10th version that the United States… Read More »ICD-11 Monthly – September 2023
Outpatient Documentation & Coding Issues, September 2023 Presented below is an analysis of new and ongoing initiatives under the Office of the Inspector General (OIG) Work Plan [1] and the Centers for Medicare & Medicaid Services (CMS) approved Recovery Audit Contractor (RAC) reviews [2] as of July 2023. The focus is on outpatient initiatives related… Read More »UASI Compliance Analysis