Medical Billing and Coding Healthcare Blog

The Centers for Medicare & Medicaid Services' (CMS) Medicare Learning Network will offer a free listening session the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA)

The program, titled "MACRA Listening Session: Quality Payment Program Proposed Rule," is scheduled to take place Tuesday, May 10, from 2:00-3:00 p.m. ET.

This listening session is an opportunity for stakeholders to provide CMS early feedback on proposed policy for the Quality Payment Program. Participants are encouraged to review the proposed rule (CMS-5517-P) prior to the program.

Space may be limited. To register, click here.

MACRA changes the way Medicare rewards clinicians for providing quality care by streamlining multiple quality programs into a new Quality Payment Program tied to Part B fee-for-service payments.

With the implementation of MACRA and the replacement of the sustainable growth rate (SGR), Medicare will pay clinicians participating in the merit-based incentive payment system or advanced alternative payment models of the Quality Payment Program beginning in 2019.

As we previously discussed, the Centers for Medicare & Medicaid Services and Centers for Disease Control and Prevention indicated they will add about 1,900 diagnosis codes and more than 3,600 hospital inpatient procedure codes to the ICD-10 coding system.

After these codes are finalized, they will go into effect October 1.

Now the American Health Information Management Association (AHIMA) is pushing for changes to a number of these ICD-10-PCS codes because, as a Journal of AHIMA column notes, "...many of the new ICD-10-PCS codes deal with cardiovascular system devices and procedures, while ICD-10-CM additions were much broader in scope."

AHIMA has requested changes to codes in the following categories:

  • SPY Fluorescence Vascular Angiography (FVA)
  • Oxidized Zirconium on Polyethylene Bearing Surfaces for Hip and Knee Arthroplasty
  • Spinal Fusion with Nano-Textured Surface
  • Intravenous Administration of Andexanet Alfa
  • Insertion of Endobronchial Coils
  • Hematopoietic Cell Transplant Donor Type
  • Minimally Invasive Aortic Valve Replacement
  • Branched Endograft Repair of Common Iliac Aneurysm
  • Intravenous Administration of Defitelio (defibrotide)
  • Administration of VISTOGARD (uridine triacetate)
  • Insertion of Spinal Bracing and Distraction System
  • Application of Biologic Wound Matrix
  • Total Anomalous Pulmonary Venous Return (TAPVR)

AHIMA also recommended changes to ICD-10-CM codes in the following categories:

  • Classification of Myocardial Infarction
  • Congenital Sacral Dimple
  • Postoperative Seroma
  • Addenda

To read AHIMA comments regarding ICD-10-PCS codes, click here.

To read AHIMA comments regarding ICD-10-CM codes, click here.

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