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Latest News

Check out the latest news on coding, billing, denial management, release of health information, privacy and security regulations and guidance here

Quarterly Update to the National Correct Coding Initiative [NCCI] Procedure-to-Procedure [PTP] Edits, Version 28.2, Effective July 1, 2022 

June 2022

NCCI third quarter edit files are available on these Medicare NCCI webpages:

Access NCCI Coding Edits Here

Office of the Inspector General (OIG) to Review a Medicare Administrative Contractor (MAC) Cost Report Settlements with Audit 

June 2022

Report Number (W-00-22-35886)

The Office of the Inspector General (OIG) to review a single Medicare Administrative Contractor (MAC), and based on the results, they may expand this work to other MAC’s.

OIG’s objective will be to:

(1) quantify the extent to which the MAC amends audit adjustments after cost reports have been audited and settled, and whether the audit adjustments contain obvious errors or are inconsistent with the law, regulations and rulings, or general instructions;

(2) quantify the effect of amended audit adjustments; and

(3) gain an understanding of the types and/or causes of amended audit adjustments.

Access Notice Here

People’s Republic of China State-Sponsored Cyber Actors Exploit Network Providers and Devices 

June 2022

Alert (AA22-158A)

Common vulnerabilities exploited by People’s Republic of China state-sponsored cyber actors PRC state-sponsored cyber actors readily exploit vulnerabilities to compromise unpatched network devices. Network devices, such as Small Office/Home Office (SOHO) routers and Network Attached Storage (NAS) devices, serve as additional access points to route command and control (C2) traffic and act as midpoints to conduct network intrusions on other entities. Over the last few years, a series of high-severity vulnerabilities for network devices provided cyber actors with the ability to regularly exploit and gain access to vulnerable infrastructure devices. In addition, these devices are often overlooked by cyber defenders, who struggle to maintain and keep pace with routine software patching of Internet-facing services and endpoint devices.

Top network device CVEs exploited by People’s Republic of China state-sponsored cyber actors: 

  • Cisco
  • Citrix
  • DrayTek
  • D-Link
  • Fortinet
  • MikroTik
  • Netgear
  • Pulse
  • QNAP
  • Zyxel

Click here for PDF Summary

ONC's Cures Act Final Rule Highlighted Regulatory Dates 

June 2022

Empowering Patients with Their Health Record in a Modern Health IT Economy

The patient is at the center of the 21st Century Cures Act. Putting patients in charge of their health records is a key piece of patient control in health care, and patient control is at the center of HHS' work toward a value-based health care system. The ONC Cures Act Final Rule implements interoperability requirements outlined in the Cures Act. Patients need more power in their health care, and access to information is key to making that happen. 

Access full guidelines here

2023 ICD-10-CM Official Guidelines for Coding and Reporting

June 2022

The Centers for Medicare and Medicaid Services (CMS) and the National Center for Health Statistics (NCHS), two departments within the U.S. Federal Government’s Department of Health and Human Services (DHHS) provide the following guidelines for coding and reporting using the

International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM). These guidelines should be used as a companion document to the official version of the ICD-10-CM as published on the NCHS website. These guidelines are a set of rules that have been developed to accompany and complement the official conventions and instructions provided within the ICD-10-CM itself. These guidelines have been approved by the four organizations that make up the Cooperating Parties for the ICD-10-CM: the American Hospital Association (AHA), the American Health Information Management Association (AHIMA), CMS, and NCHS.

Access full guidelines here

2023 ICD-10-CM Files

June 2022

The 2023 ICD-10-CM files below contain information on the ICD-10-CM updates for FY 2023. These 2023 ICD-10-CM codes are to be used for discharges occurring from October 1, 2022 through September 30, 2023 and for patient encounters occurring from October 1, 2022 through September 30, 2023.

Access full files here

CPT® Appendix T and Modifier 93: Audio-only medical services

May 2022

Make sure your billing staff knows about these changes:

• New COVID-19 CPT vaccines and administration codes

• CPT proprietary laboratory analyses (PLA) coding changes effective July 1, 2022

• New CPT Category III codes effective July 1, 2022

Access full guidelines here

Effective July 1, 2022 Update of the Hospital Outpatient Prospective Payment System (OPPS)

May 2022

Make sure your billing staff knows about these changes:

• New COVID-19 CPT vaccines and administration codes

• CPT proprietary laboratory analyses (PLA) coding changes effective July 1, 2022

• New CPT Category III codes effective July 1, 2022

Access full guidelines here

2023 ICD-10-PCS Official Guidelines for Coding and Reporting

May 2022

The 2023 Centers for Medicare and Medicaid Services (CMS) and the National Center for Health Statistics (NCHS), two departments within the U.S. Federal Government’s Department of Health and Human Services (DHHS) provide the following guidelines for coding and reporting using the International Classification of Diseases, 10th Revision, Procedure Coding System (ICD-10-PCS). These guidelines should be used as a

companion document to the official version of the ICD-10-PCS as published on the CMS website. The ICD-10-PCS is a procedure classification published by the United States for classifying procedures performed in hospital inpatient health care settings.

Access full guidelines here

Table of Contents

A. Conventions .......................................................................3

B. Medical and Surgical Section Guidelines ...................................5

2. Body System ..............................................................5

3. Root Operation..........................................................5

4. Body Part ...............................................................13

5. Approach ...............................................................16

6. Device ....................................................................17

C. Obstetrics Section Guidelines...............................................18

D. Radiation Therapy Guidelines.............................................18

E. New Technology Section Guidelines.......................................19

F. Selection of Principal Procedure...........................................20

2023 ICD-10-PCS Files

May 2022

The 2023 ICD-10 Procedure Coding System (ICD-10-PCS) files below contain information on the ICD-10-PCS updates for FY 2023. These 2023 ICD-10-PCS codes are to be used for discharges occurring from October 1, 2022 through September 30, 2023.

Access full files here

AHA Resource on ICD-10-CM Coding for Social Determinants of Health

April 2022

Hospitals and health systems are working to address their patients’ social needs and the broader social determinants of health in the communities they serve. This includes societal and environmental conditions such as food, housing, transportation, education, violence, social support, health behaviors and employment.

Any clinician can document a patient’s social needs

Access the full article here

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Congress Passes 72-Hour Federal Breach Reporting Law for Critical Infrastructure

March 2022

As part of a larger spending bill signed by President Biden on March 15, 2022, Congress passed the Cyber Incident Reporting for Critical Infrastructure Act (CIRA) to increase funding for the federal Cybersecurity and Critical Infrastructure Agency (CISA). CIRA requires companies considered to be in a “critical infrastructure” sector to notify CISA within 72 hours of a significant cyber incident and, in the case of ransomware, within 24 hours of making a payment. CISA may look to the 16 industries considered “vital” to the United States’ physical and economic security and public health or safety:

  • Chemical
  • Commercial facilities
  • Communications
  • Critical Manufacturing
  • Dams
  • Defense Industrial Base
  • Emergency Services
  • Energy
  • Financial Services
  • Food and Agriculture
  • Government Facilities
  • Healthcare and Public Health
  • Information Technology
  • Nuclear Reactors, Materials, and Waste
  • Transportation Systems
  • Water and Wastewater Systems
Access the full article here

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