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May 3, 2019
Published by Nikki Golden at May 3, 2019
Categories
ISASS sent the Center for Medicaid and Medicare Services a letter May 3, asking it to consider applying a C-code to the Barricaid Implant system. CMS C-codes are used for new technologies and new devices that are used in outpatient settings such as the Barricaid Implant system. If approved, C-codes only apply to the facility payments, and physician payment and coding is separate. Typically, technologies that gain C-code approval can see greater adoption and allow greater research and insight into outcomes and efficacy. If approved, Barricaid would receive approval for C-code status for FY 2019. See the full text of the ISASS letter to CMS Regarding Barricaid System
April 30, 2019
Published by Nikki Golden at April 30, 2019
Categories
In a letter dated April 16, 2019, ISASS asked for CMS to consider changes to a set of National Correct Coding Initiative (NCCI) edits for CPT codes 22842, Posterior segmental instrumentation (eg, pedicle fixation, dual rods with multiple hooks and sublaminar wires); 3 to 6 vertebral segments (List separately in addition to code for primary procedure), 22843, Posterior segmental instrumentation (eg, pedicle fixation, dual rods with multiple hooks and sublaminar wires); 7 to 12 vertebral segments (List separately in addition to code for primary procedure), 22844, Posterior segmental instrumentation (eg, pedicle fixation, dual rods with multiple hooks and sublaminar wires); 13 or more vertebral segments (List separately in addition to code for primary procedure) 22845, Anterior instrumentation; 2 to 3 […]
April 30, 2019
Published by Nikki Golden at April 30, 2019
Categories
The Centers for Medicare & Medicaid Services (CMS) has released its proposed rule to update the Medicare inpatient rehabilitation facility (IRF) prospective payment system (PPS) for FY 2020. CMS projects that IRF PPS payments would rise by $195 million under the proposed rule. Specifically, CMS proposes a 2.5% increase factor, based on an IRF market basket update of 3.0% reduced by a 0.5 percentage point multifactor productivity adjustment. CMS proposes to rebase and revise the IRF market basket to use a 2016 base year rather than 2012. CMS also proposes to increase the outlier threshold amount from $9,402 for FY 2019 to $9,935 for FY 2020, which would have the effect of decreasing aggregate payments by approximately 0.2%. The proposed […]
April 30, 2019
Published by Nikki Golden at April 30, 2019
Categories
The U.S. Department of Health and Human Services (HHS) announced that it would extend until June 3 the comment periods for CMS and the Office of the National Coordinator for Health Information Technology (ONC) proposed interoperability and information blocking rules. CMS also announced that as a result of public comments, it will adjust the effective dates of its policies to allow for adequate implementation timelines as appropriate. In addition, HHS released a set of frequently asked questions (FAQs) from the Office for Civil Rights (OCR), addressing HIPAA’s right of access as related to apps designated by individual patients and application programming interfaces (APIs) used by a health care provider’s electronic health record (EHR) system. The FAQs clarify, among other things, that once protected health […]