Healthcare News: CMS releases 2021 IPPS proposed rule

Why This Topic Matters

The proposed rule can affect inpatient coding workflows, hospital reimbursement, and planning for new diagnosis and procedure code sets in the coming fiscal year. It also signals payment policy changes and public comment timing that hospitals and coding professionals may need to monitor.

Article Sections

1. Overview of the FY 2021 IPPS proposed rule

   Introduces the CMS proposed rule and summarizes the main areas covered in the update. The section frames the article around inpatient payment policy and annual code-set revisions.

2. ICD-10-CM proposed updates

   Reviews the scope of proposed diagnosis code changes and the types of clinical categories affected. The section discusses the annual update process for ICD-10-CM.

3. ICD-10-PCS proposed updates

   Summarizes proposed procedure code additions and related categories in the inpatient setting. The section focuses on the ICD-10-PCS portion of the rule.

4. New MS-DRG proposal

   Describes the proposal for a new Medicare Severity Diagnosis-Related Group related to a specific therapy area. The section explains that CMS is considering changes to inpatient payment grouping.

5. Payment rate and spending projections

   Covers CMS’s projected changes to hospital operating payments and overall inpatient spending. The section also notes the broader payment adjustments included in the rule.

6. Comment period and rule timing

   Provides information about the public comment process and the timing of the final rule. The section notes the regulatory deadline discussed in the article.