Health Information Management

Q/A: Know important dates for outpatient updates

APCs Insider, August 26, 2011

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Q: Fall is sneaking up on us as we near the end of summer. What are most the important tasks that we should complete with respect to the 2012 outpatient coding updates?

A: Keeping on track with the latest outpatient updates, along with timley implementation, keeps all hospital providers compliant with outpatient requirements and helps ensure timely receipt of revenue.

These are some important dates to remember when creating revenue cycle management team agendas:

  • The ICD-9-CM 2012 update is effective October 1, 2011. Although the update is limited in anticipation of ICD-10-CM/PCS effective October 1, 2013, review the current updates because they will affect contractor local coverage determination updates. Review these policies closely to ensure continued compliant claims submission. Make sure you have ordered your ICD-9-CM Manuals, updated your systems, and examined the changes and additions by October 1, 2011.
  • CPT® 2012 updates are effective January 1, 2012. Rumblings about the new CPT codes generally begin to occur in October. This is in anticipation of the unveiling of new and revised codes by the American Medical Association in mid November. Ensure that you order CPT manuals and other resources and update your systems to accommodate changes effective January 1, 2012to ensure appropriate reporting.
  • CMS published the 2012 OPPS proposed rule July 1 and comments are due August 30. The agency will publish the final rule by November 1. All facility providers must understand the operational and payment implications that may affect them. Education must begin sufficiently early to allow review of all affected operational and billing processes and implementation of all required updates and changes by January 1, 2012.
  • HCPCS 2012 updates are also effective January 1, 2012. Typically, some changes are interspersed in the final OPPS rule. Note that this is not a complete update. Therefore, review of the files CMS publishes on its website and those that appear in 2012 coding books is necessary to ensure appropriate updating of all systems, including the chargemaster,by January 1, 2012.

Editor’s note: Andrea Clark, RHIA, CCS, CPCH, president of Health Revenue Assurance Associates, Inc., in Plantation, FL, answered this question.

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