New Coding Issues Emerge To Confront Coders

New Coding Issues to Confront Coders

 

The new codes and subsequent issues will be effective Oct. 1, 2023.

According to senior healthcare consultant Laurie Johnson, who presented the information during the series, three major issues emerged from her research and manifested themselves in her presentation —a presentation that was augmented with commentary from Erica Remer, MD, co-host for the long-running Talk Ten Tuesdays Internet broadcast.

“New technology add-on payments (NTAPs) are expected to be a game changer,” Johnson told ICD10monitor in an email. “Many NTAPs for FY23 come at a time when hospitals are losing money, since many of them are for medications,” indicating that this is one of three looming changes for 2023.

The second major change comes from the OR designation relative to CC and MCC designation, according to Johnson.

The third challenge that Johnson said was revealed during the 2023 IPPS Coding Summit relates to National Drug Codes (NDCs).

Adding the NDCs into the charge master could begin preparation for a time when an ICD-10-PCS code for a medication does not trigger the NTAP.

Johnson said the Centers for Medicare & Medicaid Services (CMS) is entertaining using NDCs in place of PCS codes to trigger the NTAP.

The use of the NDC codes in place of PCS codes will remove the need to get a PCS code for new technology add-on payments (NTAPs).  This action will also impact the Coordination and Maintenance Committee meeting agenda.

In recent years, the PCS agenda has been filled with administration of new medications and devices.  Typically, coders would not assign codes for the administration of specific medications or devices used during a procedure.

The MCE Edit #20 (Unspecified Codes) which became effective April 1, 2022.  This edit looks for unspecified laterality for ICD-10-CM codes and is triggered when the laterality is unspecified. When the edit is triggered, there is a specific response if the code cannot be updated to a specified laterality.

When downloading the on-demand series, here is reader’s guide to the content that was presented last Tuesday, Wednesday and Thursday.

2023 IPPS Summit Day 1: Master ICD-10-CM Changes

The first session features a review of FY23 changes to ICD-10-CM codes.

2023 IPPS Summit Day 2: Master ICD-10-PCS Changes

This is the second session and features a review of the hundreds of FY23 changes to ICD-10-PCS codes.

2023 IPPS Summit Day 3: MS-DRG Shifts and NTAPs

The third and final session features a review of FY23 changes to the MS-DRG methodology and the NTAPs.

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