Prepare for Year End

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.

  1. 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.
  1. 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.
  1. 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.
  1. 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.
  1. 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.
  1. 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.
  1. 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!

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Laurie M. Johnson, MS, RHIA, FAHIMA, AHIMA Approved ICD-10-CM/PCS Trainer

Laurie Johnson is currently a senior healthcare consultant for Revenue Cycle Solutions, based in Pittsburgh, Pa. Laurie is an AHIMA-approved ICD-10-CM/PCS trainer. She has more than 35 years of experience in health information management and specializes in coding and related functions. She has been a featured speaker in over 40 conferences. Laurie is a member of the ICD10monitor editorial board and is a permanent panelist on Talk Ten Tuesdays

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