AMA updates CPT codes annually, effective January 1. CMS updates HCPCS quarterly, with major updates effective every January.
The annual code changes require significant updates to each hospital’s chargemaster. Equally important are impacts on coding, documentation, reimbursement, and claims processing. 2018’s changes include:
- About 270 new CPT and HCPCS codes
- Approximately 100 CPT and HCPCS deletions
- Drug unit changes for replacement codes
- 59 code descriptions changed substantially enough to affect intended use of the CPT
- Changes to radiology reimbursement
- New modifier requirements
- Code changes to properly report quality
- Inpatient-only procedure updates
- Medicare changes in reimbursement and packaging
Because the changes are so extensive, there are many moving parts within a facility’s revenue cycle that must be updated to ensure timely and compliant billing and reimbursement. Not only are updates to the CDM necessary, but changes to documentation and department behavior, including orders, coding and billing, will be required for a complete 2018-ready revenue cycle.