AHA Coding Clinic® for HCPCS - 2021 Quarter 4; In This Issue
Updated information regarding the Medicare Inpatient Only list.
The AHA’s Coding Clinic for HCPCS, Second Quarter 2021, discussed the Center for Medicare & Medicaid Services (CMS) Calendar Year 2021 (CY 2021) Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems (OPPS/ASCPS) final rule eliminating the Inpatient Only (IPO) list. The IPO list was to be eliminated over a three-year period and 266 musculoskeletal procedures in addition to 32 anesthesia and service codes for a total of 298 codes were removed from the IPO List for CY 2021. On July 19, 2021, CMS released the CY 2022 OPPS proposed rule and requested comments regarding the potential...
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Article Overview
This article explains recent CMS and AHA Coding Clinic updates about the Medicare inpatient-only list within the Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems rulemaking process. It is useful for hospital outpatient, inpatient, surgery, anesthesia, and facility coding professionals who need to track policy changes, annual review activity, and the official CMS reference materials tied to CY 2022.
Why This Topic Matters
Changes to the inpatient-only list can affect site-of-service reporting, hospital billing workflow, and how facilities monitor annual CMS rulemaking. The article helps readers understand the policy context and identify the official code references and CMS source materials involved.
Article Sections
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CMS rulemaking and inpatient-only list policy changes
Summarizes the CMS and AHA Coding Clinic context for the Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems rulemaking cycle. Covers the broader policy discussion around the inpatient-only list and annual review process.
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Codes affected by the CY 2021 and CY 2022 updates
Describes the categories of services referenced in the update and the CMS decision to restore most previously removed services while identifying exceptions. Also notes the separate classification of an additional code for inpatient-only status.
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CMS Addendum E reference
Points readers to the CMS website resource that contains the complete list of services designated as inpatient only beginning in CY 2022.
What You Will Learn
- How CMS policy changes affected the inpatient-only list
- What types of code groups are discussed in the update
- Where CMS published the reference list for CY 2022
- Which organizations and rulemaking materials are referenced
Who Should Read This
- Hospital coders
- Outpatient facility coding staff
- Inpatient coding staff
- Anesthesia coders
- Revenue cycle professionals
- Compliance teams
- Health information management professionals
Codes Discussed
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