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Today HHS announced 10 drugs that, under the Inflation Reduction Act of 2022 (IRA), will be priced for Medicare Part D purposes by direct negotiation with their manufacturers, rather than by paying the rate offered.

 
 
Practices that perform trigger point injections (20552-20553) should read Noridian’s proposed local coverage determination (LCD) for the service. The LCD could be the model for a uniform LCD that several Medicare administrative contractors (MAC) adopt.
 
 
By now, most practices should be aware of the JW and JZ modifiers, which you are to append to codes for single-dose drug containers that you bill to Medicare Part B.
 
 
The initial proposals for CY 2024 are out, and medical groups should brace for rate cuts: CMS is floating a net 3.4% reduction to the Medicare Part B conversion factor.
 
The agency also provided a sneak peek of an array of new codes, including the return of add-on office visit code G2211, major quality-reporting updates and separate coding opportunities for “community health integration services,” among other changes, according to the proposed 2024 Medicare physician fee schedule released today.
 
 
Prepare for several hundred new ICD-10-CM codes now finalized to take effect Oct. 1. On June 16, CMS announced the additions of 395 new diagnosis codes, 25 deletions to the ICD-10-CM code set and 13 revisions. In addition, there are hundreds of changes to tabular instructions added in the addenda for the FY 2024 code set.

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