To do each January

Review 2017 CPT code changes

Review all changes to guidelines, notes, and instruction in the book

Highlight changes in the book’s index pertinent to your specialty, and review those changes

Highlight changes in the tabular section pertinent to your specialty

Create a documentation “cheat sheet” of 2017 updates that must be documented differently for coders to capture the needed information and distribut it to clinicians

Review and update superbills, chargmasters, etc.

Upload software chanes

Train coding and billing staff on changes

Review PQRS changes from CMS

Communicate with payer/provider reps regarding reimbursement and overage issues

Archive last year’s books

Comments

MEDICARE PREVENTIVE SERVICES FROM MEDICARE LEARNING NETWORK

This is a link to further information on the Medicare Preventive Services. The layout of it reminds me of a bingo card! Medicare Learning Network is the educational arm of Centers for Medicare and Medicaid Service (CMS). Remember this is further information on different types of screenings available to Medicare beneficiaries. https://www.cms.gov/Medicare/ Prevention/PrevntionGenInfo/ medicare-preventive-services/ MPS-QuickReferenceChart-1. html#AWV Disclaimer: This guidance is to be used for an easy reference; the ICD-9-CM and ICD-10-CM code books and the Official Guidelines for Coding and Reporting are the authoritative references for accurate and complete coding. This blog may contain references or links to statutes, regulations, or other policy materials. It is not intended to take the place of either the written law or regulations. The information presented herein is for general informational purposes only and is accurate as of the date of publication.

Table VI-4. Disease Hierarchies for the 2017 CMS-HCC Model

If the Disease Group is Listed in this column… …Then drop the Disease Group(s) listed in this column is found here : Announcement of Calendar Year (CY) 2017 Medicare Advantage Capitation Rates and Medicare Advantage and Part D Payment Policies and Final Call Letter Found at: https://www.cms.gov/Medicare/HealthPlans/MedicareAdvtgSpecRateStats/Downloads/Announcement2017.pdf P 87 If the Disease Group is Listed in this column… …Then drop the Disease Group(s) listed in this column Disclaimer: This guidance is to be used for an easy reference; the ICD-9-CM and ICD-10-CM code books and the Official Guidelines for Coding and Reporting are the authoritative references for accurate and complete coding. This blog may contain references or links to statutes, regulations, or other policy materials. It is not intended to take the place of either the written law or regulations. The information presented herein is for general informational purposes only and is accurate as of the dat...

Signature requirements

The Medicare Program Integrity Manual contains the guidance around signature requirements. They are found in chapter 3. 3.3.2.4 - Signature Requirements This material was also covered in the Part AB November 2025 webinar by Noridian entitled: Signature Requirements Disclaimer: This guidance is to be used for an easy reference; the ICD-9-CM and ICD-10-CM code books and the Official Guidelines for Coding and Reporting are the authoritative references for accurate and complete coding. This blog may contain references or links to statutes, regulations, or other policy materials. It is not intended to take the place of either the written law or regulations. The information presented herein is for general informational purposes only and is accurate as of the date of publication.

HCC Blog by Caridad

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