ICD-11 Implementation Date

Medical Coding

When will we implement ICD-11 for use on healthcare claims in the US? That’s a question everyone wants the answer to, but the true answer is – no one knows. However, when we know the answer on the following three key questions, we’ll be able to predict the implementation date in the US. Will the…

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FY 2022 IPPS MS-DRG Final Rule Updates

The annual final rule from the Centers for Medicare and Medicaid Services (CMS) regarding the Inpatient Prospective Payment System (IPPS) MS-DRGs was issued on August 2, 2021. [1] This final rule is effective October 1, 2021. [2] It was proposed in April that 3,490 unspecified diagnosis codes currently designated as either CC or MCC would…

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CY 2022 OPPS Proposed Rule

On July 19th the Centers for Medicare and Medicaid Services (CMS) released the calendar year (CY) 2022 Outpatient Prospective Payment System (OPPS) proposed rule. [1] After a comment period, the final rule will be published in November 2021. Notable changes proposed for CY 2022 include: A net increase in OPPS payment rates of 2.3% over…

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ICD-11 Post-Coordinated Code Clusters

UASI At A Glance

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…

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UASI in JAHIMA: COVID-19 ICD-10-CM Coding Timeline for Outpatient Services

UASI Solutions

By Mary H. Stanfill, MBI, RHIA, CCS, CCS-P, FAHIMA; Pat Maccariella-Hafey, RHIA, CDIP, CCS, CCS-P, CIRCC; Christi LeBlanc, MBA, RHIA; and Janice Noller, RHIA, CDIP, CCS, CICA When COVID-19 emerged in early 2020, new ICD-10-CM codes to identify this condition were not available. Subsequent ICD-10-CM codes and guidelines for reporting COVID-19 changed many times as the pandemic…

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Implementation Guidance for FY21 E/M Code Changes

On January 1, 2021, the American Medical Association will implement the largest change to the CPT* evaluation and management (E/M) office visit codes in almost 30 years. The code changes impact some of the most frequently used E/M codes (office and other outpatient visit codes 99201-99205 and 99211-99215) requiring significant changes in provider office and…

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COVID-19 Data Quality Best Practices

UASI Solutions

In order to ensure the accuracy and reliability of administrative COVID-19 data capture for both internal and external uses, HIM professionals should follow best practice steps. The application of best practices in the steps below give examples using data coded with the standard transaction code sets. However, these steps are repeatable to explore logical, expected…

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Data Quality Management Best Practices

UASI Solutions

General best practices for interactive data quality management in both inpatient and ambulatory care settings involve the following iterative steps. Identify specific data elements that can be or should be collected for a specific data capture need. This includes identifying all relevant data fields, data types, data definitions, and the associated data values using the…

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An Overview of the FY 2021 Evaluation and Management Code Changes

For the first time since 1997 the American Medical Association (AMA), in collaboration with the Centers for Medicare and Medicaid Services (CMS), will implement significant changes to the Evaluation and Management (E/M) office visit codes and guidelines. This paper provides an overview of the E/M changes that will be implemented January 1, 2021. Background and…

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