The Centers for Medicare & Medicaid services (CMS), Centers for Disease Control and Prevention (CDC) and National Center for Health Statistics (NCHS) jointly released the official ICD-10 code changes for fiscal year (FY) 2020. This is the fourth such update to occur since ICD-10 was first officially implemented in the U.S. back in October of 2015. These code changes will go into immediate effect as of Tuesday, October 1, 2019. However, it is important to note that any claims with earlier service dates (on or before September 30, 2019) must continue to use the codes from FY2019.

In mid-August, the Centers for Medicare & Medicaid Services (CMS) released its 2020 Quality Payment Program Proposed Rule Overview. This document outlines changes to Quality Payment Program (QPP) policies that will take effect in the upcoming 2020 year, as well as proposed changes for 2021. It is also a summarization of the far more detailed (and roughly 1700 page long) CY 2020 Revisions to Payment Policies document. One section that is likely to be of the most interest to healthcare providers deals with new modifications to the Merit-Based Incentive Payment System (MIPS). In this article, we will be looking at these MIPS 2020 changes, particularly those that are of concern to specialty healthcare practices in fields such as dermatology, ophthalmology, plastics/aesthetics and orthopedics.

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There is a tug of war underway in healthcare, and physicians are sitting squarely in the middle. On one side, patients are demanding providers’ attention and expertise to address often complex medical conditions. On the other, there are evolving regulatory requirements, such as those found in the 2019 Quality Payment Program (QPP), which requires providers to regularly submit detailed measures of quality, cost, interoperability and more. As a result of the constant push and pull, physicians are becoming increasingly frustrated and disheartened. Most entered the profession to treat and care for patients, however, they are becoming sidetracked as they try to effectively demonstrate their performance to receive adequate reimbursement.

Remember learning how to ride a bike? Although it was slightly nerve-wracking when your parents took the training wheels off, it was also empowering. You had moved beyond just getting the hang of things and were really making progress. You could travel past the end of the block and explore new possibilities. In some ways, this is similar to what healthcare organizations are going through with the 2019 Outpatient Prospective Payment System (OPPS) Rules.

With Valentine’s Day approaching, people are starting to celebrate love and friendship. However, given the competing priorities your front office staff deals with each day, they may have trouble putting their hearts into any festivities.

The coming festivities will bring a thrill of excitement for many people as they prepare to ring in 2019. For healthcare providers, this time of year can also present some unusual patient care situations, which could lead to a little atypical ICD-10 coding. Here is a brief look at several codes that might be getting increased attention in the next few weeks.

CMS released the Quality Payment Program Year 3 Final Rule on November 1st. The rule included the removal of 26 Quality Measures, the addition of 10 new Quality measures, and significant changes to the Promoting Interoperability category of the program. Nextech will be releasing more information on these changes in the near future, including a video outlining the changes with tips to prepare for the coming year. Until then, here are a few steps to get you started.