PPS 2013:
Get Ready: CMS Moves Forward With M1024 Changes
Published on Fri Dec 21, 2012
PPS 2013 clarifies and changes resolved condition reporting. Come Jan. 1, the way you answer M1024 -- Payment diagnoses will change drastically. The good news is the instructions for answering this item will be much easier to follow. The bad news is that, thanks to grouper logic changes, your reimbursement may take a hit. Changes to the grouper logic will encompass three areas: 1. Restrict M1024 to Fractures Only Starting in 2012, the Centers for Medicare & Medicaid Services will modify instructions for the payment diagnosis field to restrict awarding case mix points to aftercare for fracture situations alone. CMS plans to alter the grouper logic to award points only when V54.1x (Aftercare for healing traumatic fracture) or V54.2x (Aftercare healing pathological fracture) is reported as a primary or secondary diagnosis and paired with a fracture code from the newly released V code/Fracture code pairing listing. This will limit M1024 [...]
