ICD-10

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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 […]

CMS Beneficiary Notices

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Both Medicare beneficiaries and providers have certain rights and protections related to financial liability under the Fee-for-Service (FFS) Medicare and the Medicare Advantage (MA) Programs. These financial liability and appeal rights and protections are communicated to beneficiaries through notices given by providers. Hospitals are required to deliver the Important Message from Medicare (IM), CMS-R-193 to all […]

CWTC [Episode 95] 7th Character for Comorbidities, Bilateral LE Weakness, Timed Therapy Minutes

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Welcome to Coffee with the Coder®, our conversation with Paula Digby and her team to address issues, observations and questions for Health Information Management professionals, physicians, auditors, payors and students. You are invited to listen in for ten to twenty minutes every other Monday and to submit your favorite questions or comments for Coffee with […]

MLN Matters Articles Index, FY2004 – FY2019

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What is MLN Matters? The Centers for Medicare & Medicaid Services (CMS) is committed to partnering with the Medicare physician, provider, and supplier communities to ensure that Medicare beneficiaries receive all of the health care services to which they are entitled. MLN Matters are national articles designed to inform the physician, provider, and supplier community […]

COVID-19 FAQs from CMS

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Recommendations for re-opening facilities for non-emergent non-COVID-19 healthcare CMS Press Releases on COVID-19 April 30, 2020 Update April 27, 2020 Update April 14, 2020 Update Open Payments Program FAQ (Apr 3, 2020) March 30, 2020 Update On March 6, 2020, the Centers for Medicare & Medicaid Services (CMS) issued frequently asked questions and answers (FAQs) […]

Modifier CR and DR during COVID-19

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Clarification on the DR (disaster related) and CR (catastrophe/disaster related) modifiers was issued by CMS on June 1, 2020 in this document.  The clarifications are the only changes made to this guidance.

ReOpening America Guidelines – Phase 1 – April 19, 2020

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From the Centers for Medicare and Medicaid Services: The United States is experiencing an unprecedented public health emergency from the COVID-19 pandemic. Healthcare facilities in some areas are stretched to their limits of capacity, and surge areas have been needed to augment care for patients with COVID-19. To expand capacity to care for these patients […]

IRF Data Files from CMS (2020 and 2019)

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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

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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 […]