Reimbursement Intelligence Digest — Week of August 10, 2026
### Inpatient (IPPS) - **Review IPPS Updates**: Analyze CMS Transmittals R13812CP and R13851CP for FY 2027 MS-DRG and IRF PPS updates. Verify if exis
Actions Required This Week
Inpatient (IPPS) - Review IPPS Updates: Analyze CMS Transmittals R13812CP and R13851CP for FY 2027 MS-DRG and IRF PPS updates. Verify if existing systems align with updated PPS and DRG coding requirements. Action required by August 17, 2026.
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Quick answers
What updates are required for ICD-10 codes this week?
Review and implement changes from CMS Transmittals R13903OTN and R13906OTN relating to ICD-10 revisions. Verify code accuracy and make any necessary system updates by August 17, 2026.
What changes are introduced in the IPPS Final Rule?
The IPPS Final Rule (FR-2026-15833) introduces adjustments to Hospital Inpatient Payment Systems, quality program requirements, and health IT standards, effective October 1, 2026.
What actions should be taken regarding FDA approvals in Hematology and Oncology?
Review coding frameworks for integration of newly approved entities like LYNOZYFIC and PLUVICTO. Verify updated billing codes and educate relevant staff on the drug's implications and administration.
When do updates to hospice rates and cap take effect?
The updates to hospice payment rates, caps, and indexes outlined in CMS Transmittal R13872CP take effect on October 1, 2026. Implement all necessary adjustments by this date.
Content summarized from publicly available federal publications including CMS, MAC contractors, and the Federal Register. CLV Intelligence is not affiliated with or endorsed by any government agency. This is not legal or medical advice.