Industry Notes: CMS Issues New 'K' Codes

Why This Topic Matters

These updates affect claim submission, documentation, and diagnosis reporting workflows across multiple service lines. Staying current can help reduce denials, avoid compliance issues, and support more accurate billing under Medicare rules.

Article Sections

1. New orthotics codes from CMS

   This section discusses new Medicare orthotics coding guidance and the CMS transmittal announcing the update. It also notes the effective date and general reimbursement context.

2. MAC clarifies modifier 22 submissions

   This section summarizes contractor guidance on documentation and claim submission practices related to an established modifier. It addresses how a Medicare administrative contractor is advising providers to support claims review.

3. Home health coders: eliminate manifestation codes as primary

   This section covers an upcoming home health claims edit and the related ICD-9-CM diagnosis reporting issue. It focuses on sequencing requirements and Medicare edits for agency claims.

4. Hospice drug reporting guidance

   This section introduces a Medicare contractor reference tool for reporting prescription drugs on hospice claims. It discusses general billing and reporting considerations for hospice drug entries.