Prepare for Year End

It’s hard to believe that we are at the end of the year.  I thought that I would review the year end check to help in your preparations.

1. New CPT® codes for Jan. 1, 2024.
   • Check/update your chargemaster with new, revised, or deleted codes.
   • Watch for January 2024 Addendum B for changes in status indicators (inpatient designations). Note:  at the time of printing, Addendum B for January 2024 was not published.
   • The new payment rate for professional fees begins Jan. 1.
   • Remember that CPT updates quarterly.
   • Review new codes with coders to prepare them for new procedures that the facility may be performing.

2. New HCPCS codes for Jan. 1, 2024.
   • Check/update your chargemaster with new, revised, or deleted codes.
   • Check that your prices are current.
   • Some of the HCPCS codes are procedures. Review these codes with the coders to ensure that they are aware.
   • Remember that the HCPCS codes have a quarterly update.

3. Schedule your inpatient and outpatient coding review.
   • Determine the focus of the review – missing charges, missed reimbursement, coding accuracy, coder annual review information, etc.
   • Determine the time frame to review. The federal fiscal year changed on Oct. 1, 2023, to FY24.

4. Your chargemaster must be updated by Jan.1, 2024.
   • The consequences of not updating the chargemaster are missed reimbursement, decrease in clean claims rate, increased denials, etc.
   • Create/update your price transparency file, if appropriate. The penalties for not having price transparency are high.
   • Review services to determine if you have any MS-DRG Add-On Payment services/devices/medications. These services must have the ICD-10-PCS code assigned to trigger the add-on payment. If the chargemaster does not permit ICD-10-PCS codes, then communicate with the coding staff the items that require the ICD-10-PCS codes.

5. Review the revenue cycle key performance indicators.
   • Identify which areas are not performing well.  Develop a strategy to improve.
   • Utilize technology to improve the revenue cycle.
   • Establish quarterly meetings to review key performance indicators.

6. Discuss education needs. This conversation should include everyone in the revenue cycle (coders, billing specialists, clinical documentation integrity staff, utilization review/case managers, patient access and physicians).
   • Determine areas for education.
   • Review ICD-10-CM/PCS and CPT guidelines for 2024 with the coding staff.
   • Plan the type of education that will be beneficial for that area.
   • Assess the results after the education.

7. Update facility-specific coding guidelines with any changes based on your year-end review. Maintain a copy of the previous version for your files.

I wish you all a wonderful holiday season!  See you all in January 2024!