CMS Spring News: Check Out Special Enrollment Periods, QPP Resources, and Quarterly Updates

CMS spring deadlines are coming up!

How are you doing this February? I’m looking at some snow, myself. But these three news pieces from CMS show that spring is right around the corner. Don’t miss these deadlines on MIPS suggestions, special enrollment, and HCPCS Q2 implementation.

1. By March 1: Make Your Voice Heard on MIPS

If you’ve got suggestions for future MIPS Advancing Care Information measures and improvement activities, CMS has put out the call for input.

For the Improvement Activities Performance Category, the submission period for suggestions for 2019 activities lasts until March 1, 2018. For Advancing care 2020 measure ideas, you have until June 29, 2018.

The Feb. 8 MLN Connects includes a link to submission forms under “MIPS: Call for Advancing Care Information Measures and Improvement Activities.”

Bonus QPP tip: That same MLN Connects includes “Quality Payment Program: Advanced APM Table,” with a link to a table showing current APMs.

2. By March 31: Complete Enrollment in Puerto Rico and U.S. Virgin Islands

CMS extended enrollment periods for people in Puerto Rico and the U.S. Virgin Islands affected by the 2017 hurricanes. The special enrollment period ends March 31, 2018. See the media release for full details, but here’s the gist.

For the Federal Health Insurance Exchange, people affected by the hurricanes in Puerto Rico and the U.S. Virgin Islands who moved to states using the Exchange may request to enroll during this extension period.

For Medicare, people affected by the 2017 hurricanes in Puerto Rico and the U.S. Virgin Islands may enroll, dis-enroll, or switch plans until March 31, 2018.

3. By April 1: Ease Into Q2 Updates With HCPCS Already Available

CMS has posted HCPCS G code and other non-C code changes effective April 1, 2018. (If you subscribe to TCI SuperCoder online resources with code search, you can see the upcoming changes by going to the Coding Tools page. Choose Upcoming Changes from the Coding menu.)

Codes for the Medicare Diabetes Prevention Program dominate the G code additions, so be sure to check those out if you code for the MDPP.

The other changes include six additions or revisions to pricing modifiers related to prescribed amounts of stationary oxygen.

Also watch for revisions to coding for biosimilar biological products. Currently, you report these code/modifier combinations for the drugs named:

  • Zarxio: Q5101-ZA
  • Inflectra: Q5102-ZB
  • Renflexis: Q5102-ZC

But with the April changes, ZA, ZB, ZC, and Q5102 will be discontinued. Instead you’ll use these codes:

  • Revised: Q5101 (Injection, filgrastim-sndz, biosimilar, (Zarxio), 1 microgram)
  • Added: Q5103 (Injection, infliximab-dyyb, biosimilar, (Inflectra), 10 mg)
  • Added Q5104 (Injection, infliximab-abda, biosimilar, (Renflexis), 10 mg).

What About You?

Which of these news pieces are you most interested in? How do you keep up with news from CMS?




Deborah works on a wide range of TCI SuperCoder projects, researching and writing about coding, as well as assisting with data updates and tool development for our online coding solutions. Since joining TCI in 2004, she’s covered the ins and outs of coding for radiology, cardiology, oncology and hematology, orthopedics, audiology, and more.

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