COVID-19 New ICD-10-CM Code

On February 24, 2020, in Documents, by AQ-IQ LLC

Responding to the public health emergency of the 2019 Novel Coronavirus, a new ICD-10-CM code has been created by the World Health Organization. The code, U07.1, 2019-nCoV acute respiratory disease) has been established and will be added to the next update of ICD-10-CM in October, 2020. The Centers for Disease Control and Prevention (CDC) issued […]

NCCI Resources

On January 6, 2020, in Documents, by AQ-IQ LLC

CMS originally developed the Medically Unlikely Edit (MUE) program to reduce the paid claims error rate for Part B claims. The first edits were implemented January 1, 2007. Subsequently there have been quarterly updates increasing the number of edits. In 2008, CMS has been refining the edits based on 100% submitted claims data from a […]

OPPS Final Rule CY2020

On November 17, 2019, in Documents, by AQ-IQ LLC

The policies in the final rule will further advance the agency’s commitment to increasing price transparency. It includes requirements that would apply to each hospital operating in the United States.  This final rule implements Section 2718(e) of the Public Health Service Act and improves upon prior agency guidance that required hospitals to make public their […]

Physician Fee Schedule 2020

On November 4, 2019, in Documents, by AQ-IQ LLC

On November 1, CMS issued a final rule that includes updates to payment policies, payment rates, and quality provisions for services furnished under the Medicare Physician Fee Schedule (PFS) effective on or after January 1, 2020. Payment Provisions: Ratesetting and conversion factor  CMS is finalizing a series of standard technical proposals involving practice expense, including […]

IRF-PAI Manual

On October 14, 2019, in Documents, by AQ-IQ LLC

FY 2020 Information IRF-PAI (version 4.0 FINAL) – Effective October 1, 2020 (FY 2021), as proposed in the FY 2020 IRF PPS final rule. Change Table listing differences from the previous version IRF-PAI Manual Version 3.0 – This manual contains information regarding data collection on the IRF-PAI version 3.0, effective October 1, 2019. Please note that the IRF-PAI Manual […]

CMS Data Files for IRFs (2018 and prior)

On October 2, 2019, in Archives, Documents, by AQ-IQ LLC

FY 2018 IRF PPS Final Rule Data Files (82 FR 36238) IRF Rate Setting Final Rule (82 FR 36238)  This file contains data for each of the 1,140 inpatient rehabilitation facilities used to estimate the policy updates in the final inpatient rehabilitation prospective payment system regulation. The methodology used to update the payment data is described […]

ICD-10

On October 1, 2019, in Documents, by AQ-IQ LLC

On October 1, 2015, the ICD-9 code sets used to report medical diagnoses and inpatient procedures were replaced by ICD-10 code sets. The transition to ICD-10 is required for everyone covered by the Health Insurance Portability Accountability Act (HIPAA). Please note, the change to ICD-10 does not affect CPT coding for outpatient procedures and physician services. Click […]

IRF Data Files from CMS (2020 and 2019)

On September 20, 2019, in Documents, by AQ-IQ LLC

FY2020 Final Rule Data Files Download for FY2020 (zip) includes: IRF Wage Index Final Rule – These files contain the proposed urban and rural Core-Based Statistical Area FY 2020 IRF wage index tables. IRF Rate Setting Final Rule – This file contains data for each of the 1,122 inpatient rehabilitation facilities used to estimate the policy updates in […]

Physician Fee Schedule and Quality Payment Program CY2020 Proposed Rule

On August 15, 2019, in Documents, by AQ-IQ LLC

As part of CMS’s annual changes to the Medicare Physician Fee Schedule and Quality Payment Program, the agency’s proposals are aimed at reducing burden, recognizing clinicians for the time they spend with patients, removing unnecessary measures and making it easier for them to be on the path towards value-based care.  Last year, the Trump Administration finalized […]