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2015 IPPS Proposed Rules Detailed

Michelle A. Leppert, CPC, May 1, 2014

The focus of Medicare's Inpatient Prospective Payment System proposed rules is squarely on achieving reductions in hospital-acquired conditions and hospital readmissions, and on value-based purchasing.

CMS' 2015 IPPS proposed rule, released April 30, focuses on quality measures, such as the hospital-acquired condition (HAC) reduction, readmissions reduction, and hospital value-based purchasing (VBP) programs.

CMS also suggested that it intends to implement ICD-10 implementation on October 1, 2015. On page 648 of the rule, CMS states, "The ICD-10-CM/PCS transition is scheduled to take place on October 1, 2015. After that date, we will collect nonelectronic health record-based quality measure data coded only in ICD-10-CM/PCS."

"This is not unexpected," states James S. Kennedy, MD, CCS, president of CDIMD in Smyrna, Tennessee. "Even so, ICD-10 advocates, such as the ICD-10 Coalition, and CMS have their work cut out for them to make ICD-10 more palatable for physicians and their advocacy groups, such as the AMA and the MGMA, as to not have it delayed again by Congress."

CMS seems to acknowledge this uncertainty by stating on page 128, "As of now, the Secretary has not implemented this provision under HIPPA (sic)."

In two additional places (p. 1065 and p. 1074), CMS states, "ICD-10 will officially be implemented on October 1, 2015."

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