It’s hard to believe that we are at the end of the year. I thought that I would review the year end check to help in your preparations.
- New CPT® codes for Jan. 1, 2024.
- Check/update your chargemaster with new, revised, or deleted codes.
- Watch for January 2024 Addendum B for changes in status indicators (inpatient designations). Note: at the time of printing, Addendum B for January 2024 was not published.
- The new payment rate for professional fees begins Jan. 1.
- Remember that CPT updates quarterly.
- Review new codes with coders to prepare them for new procedures that the facility may be performing.
- New HCPCS codes for Jan. 1, 2024.
- Check/update your chargemaster with new, revised, or deleted codes.
- Check that your prices are current.
- Some of the HCPCS codes are procedures. Review these codes with the coders to ensure that they are aware.
- Remember that the HCPCS codes have a quarterly update.
- Schedule your inpatient and outpatient coding review.
- Determine the focus of the review – missing charges, missed reimbursement, coding accuracy, coder annual review information, etc.
- Determine the time frame to review. The federal fiscal year changed on Oct. 1, 2023, to FY24.
- Your chargemaster must be updated by Jan.1, 2024.
- The consequences of not updating the chargemaster are missed reimbursement, decrease in clean claims rate, increased denials, etc.
- Create/update your price transparency file, if appropriate. The penalties for not having price transparency are high.
- Review services to determine if you have any MS-DRG Add-On Payment services/devices/medications. These services must have the ICD-10-PCS code assigned to trigger the add-on payment. If the chargemaster does not permit ICD-10-PCS codes, then communicate with the coding staff the items that require the ICD-10-PCS codes.
- Review the revenue cycle key performance indicators.
- Identify which areas are not performing well. Develop a strategy to improve.
- Utilize technology to improve the revenue cycle.
- Establish quarterly meetings to review key performance indicators.
- Discuss education needs. This conversation should include everyone in the revenue cycle (coders, billing specialists, clinical documentation integrity staff, utilization review/case managers, patient access and physicians).
- Determine areas for education.
- Review ICD-10-CM/PCS and CPT guidelines for 2024 with the coding staff.
- Plan the type of education that will be beneficial for that area.
- Assess the results after the education.
- Update facility-specific coding guidelines with any changes based on your year-end review. Maintain a copy of the previous version for your files.
I wish you all a wonderful holiday season! See you all in January 2024!
