HCPro, JustCoding Inpatient - 2016 Issue 17 (May)
Healthcare News: CMS requests changes to MCE in 2017 IPPS proposed rule
May 3rd, 2016
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Article Overview
This article explains that CMS, in the FY 2017 IPPS proposed rule, is reviewing requested changes to the Medicare Code Editor used in Medicare claims processing. It is aimed at coding, billing, and reimbursement professionals who track ICD-10-related edit logic, claim screening tools, and proposed regulatory updates. The article focuses on the broad areas CMS says it is examining, the rationale for seeking public comment, and the rulemaking timeline.
Why This Topic Matters
Updates to claim-editing software can affect how Medicare claims are screened and reviewed before payment classification, so providers and coding teams need to monitor proposed changes and comment opportunities.
What You Will Learn
- What CMS says prompted the review of Medicare Code Editor changes
- Which categories of edit issues are being examined in the proposed rule
- How the proposed rule fits into the Medicare claims-processing workflow
- What the comment and implementation timeline is for the rulemaking process
Who Should Read This
- Medical coders
- Coding managers
- Billing staff
- Revenue cycle professionals
- Compliance teams
- Hospital inpatient coding staff
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