CMS Coding Update 2023

• Only 2% cut in Medicare payment 
  • 8.5% Medicare cut averted with year-end legislation
• Telehealth extended through 2024
  • Current codes for provision of telehealth service will remain unchanged this year
• Update to E/M codes
  • Change documentation requirements and use Medical Decision Making or Total Time the day of service to determine level of service 
  • When using total time and the time exceeds the highest-level code - a prolonged services code can be added
  • Initial Inpatient/Observation codes (99221-3)   
    • *Note:  observation visits to use these codes as all observation specific codes have been deleted
  • Subsequent Inpatient/Observation codes (99231-3)
  • Same day observation/discharge codes (99234-6)
  • Inpatient consultation codes (99252-5)
  • Outpatient consultation codes (99242-5)

• New abdominal wall hernia codes any method (open, laparoscopic, robotic) based on size, reducible/incarcerated and initial/recurrent
  • The new codes have zero-day global period so all preop visits and postoperative visits are billable using outpatient or inpatient E/M visit codes
  • Mesh placement is included in the new hernia codes
  • If you are removing the mesh, there is a new code for removal
  • All abdominal wall hernia types are included: epigastric, ventral, umbilical and parastomal  
  • Inguinal, femoral and lumbar hernias are excluded from this change