Health Information Management

Pay-per-view: Providers need more time to analyze CMS’ proposed bundled payment model

APCs Insider, November 13, 2015

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Providers know the drill for addressing and operationalizing CMS' annual IPPS and OPPS updates, along with the usual ICD-9-CM and CPT® coding changes. The industry has become used to CMS' timetable for releasing inpatient and outpatient proposed and final rules and knows that it has to be ready to go live with coding, billing, and operational changes October 1 and January 1, respectively.
Knowing when major changes are expected helps but doesn't necessarily make them easier to address, especially when it feels like things are changing on a daily basis in healthcare. Providers also have only 60 days to implement new rules—and this fall will prove to be a very challenging time. It is a landmark moment, with the U.S. finally moving from ICD-9-CM to ICD-10-CM and ICD-10-PCS—the first major code set change for the inpatient setting in nearly 40 years.
If all this wasn't enough to take on, this year CMS surprised us by releasing another large proposed rule during the same time period it released the OPPS and the Medicare Physician Fee Schedule proposed rules. The proposed rule on Comprehensive Care for Joint Replacement, if finalized, will also contribute to increased workload for those providers impacted by it. Thankfully, not all providers will be affected by this proposed rule.


Continue reading "Providers need more time to analyze CMS' proposed bundled payment model" on HCPro’s website. Subscribers to Briefings on APCs have free access to this article in the November issue. 

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