News: FY 2022 IPPS Proposed Rule released

Suggested changes for the fiscal year (FY) 2020 Inpatient Prospective Payment System (IPPS) payment rule for acute and long-term care hospitals were released this week, Tuesday, April 27. The IPPS governs how hospitals get paid for services they provide to Medicare patients. Every year, CMS weighs emerging and ongoing healthcare concerns alongside healthcare reform initiatives and offers its plan for changes to the public for comment.

Some years, these recommendations represent drastic changes in the healthcare delivery system—like when CMS began categorizing patient care into DRGs under the FY 1983 IPPS final rule and when it adopted MS-DRGs in 2007. Other years, CMS makes minimal adjustments shifting DRG weights, changing diagnosis designations from CCs to MCCs, or adding or subtracting relevant ICD-10-CM/PCS codes.

After public comment, which CMS considers, the agency releases a final rule, usually in late July which then takes effect on October 1.

This year proposed updates include 153 new diagnosis codes, 22 revised codes, and 30 invalidated codes. To view the full list of ICD-10-CM changes as well as ICD-10-PCS updates, visit the CMS website. ACDIS’ Regulatory Committee previously submitted comments to CMS, urging it to consider a number of Z-codes, representing specific social determinants of health, be given CC/MCC designation.

The ACDIS Regulatory Committee will be further examining the CMS IPPS proposal and providing additional feedback to the CDI community, along with templates for CDI specialists and programs to provide their own comments to CMS in the coming weeks.

Editor’s Note: ACDIS members can find additional information about Regulatory Committee initiatives under the “Thought Leadership” tab on the ACDIS website.