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April reminders: New ICD-10-CM update, no NCCI update

Make sure your practice is using the ICD-10-CM codes and guidelines that went into effect April 1. The update includes 42 new codes and revised social determinants of health (SDOH) guidelines. You can check your practice’s coding software by entering a few of the new codes, such as Z55.6 (Problems related to health literacy) and Z59.12 (Inadequate housing utilities). Contact your vendor and remind them they need to run an update if the codes aren’t in your system.
Part B News subscribers can download a spreadsheet of the code changes from the Tool of the Month section.
You should also remind staff that CMS will not update the National Correct Coding Initiative (NCCI) files in April. Your practice should continue to use the current set of procedure-to-procedure edits and medically unlikely edits for Medicare – and Medicaid – until the July 1 update goes into effect.
Make sure that staff are aware that the delay could have broader impacts. For example, according to a claims processing alert by Medicare administrative contractor (MAC) Palmetto GBA, CMS increased the MUEs for Q0092 (Set-up portable X-ray equipment) from two units of service a day to four. “The change is retroactive to January 1, 2023, but cannot be implemented until the July 1, 2023, MUE file is updated,” Palmetto announced March 23.
Blog Tags: CMS, ICD-10
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