ICD-11 Monthly – October 2023
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…
FY 2024 MS-DRG Changes
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
Continued Discussion Surrounding RA/HCC V28 Changes
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…
ICD-10-PCS 2024 Updates
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:
Changes Coming to Risk Adjustment & Hierarchical Categories
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…
2024 ICD-10-CM Updates
It’s that time of year again. Below you will find a guide for the 2024 ICD-10-CM updates. Topics covered are:
ICD-11 Monthly – September 2023
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…
UASI Compliance Analysis
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…
Coding Tips: Maintenance of the ICD-10-CM & ICD-10-PCS Coding Systems
The Centers for Medicare & Medicaid (CMS) announced in the fiscal year 2022 Hospital Prospective Payment System final rule published on August 2,2021 that it was adopting an April 1 implementation date for ICD-10-CM and ICD-10-PCS code updates, in addition to the annual October 1 update, beginning with April 1, 2022. The April 1 implementation…
Comparing Codes Across ICD Versions: Spinal stenosis
The WHO ICD-11 classification is very different from the 10th version that the United States modified to create the ICD-10-CM code set that is used for reporting healthcare services on claims in the US today. In monthly code comparisons, we’ve looked at codes that are pre-coordinated or post-coordinated in ICD-11 and compared them with the…
ICD-11 Monthly – August 2023
Comparing Codes Across ICD Versions: Cholecystitis with cholelithiasis By: Mary H. Stanfill, MBI, ACHIP, RHIA, CCS, CCS-P, FAHIMA The WHO ICD-11 classification is very different from the 10th version that the United States modified to create the ICD-10-CM code set that is used for reporting healthcare services on claims in the US today. One distinct…
FY 2024 ICD-10-CM Official Guidelines for Coding and Reporting
The FY 2024 ICD-10-CM guidelines have been released and are now available for review. While there aren’t a large amount of guideline changes and updates, there are several notable highlights in Section C, Chapter-Specific Coding Guidelines to be aware of: The complete ICD-10-CM Official Guidelines for Coding and Reporting document can be found at :…