The AMA updates the ICD-10® code set annually on October 1st. Per communication from CMS on September 30, 2025, this year’s update affects the exclusion criteria for measure 491 as revisions are made to Lynch Syndrome ICD-10 codes. To maintain the measure’s integrity for 2025 reporting, the performance year for measure 491 is adjusted to 1/1/25 – 9/30/25. Scoring will not be negatively affected by this change, provided case minimums and data completeness are met.
The measure sets for radiology and pathology are relatively small so these updates rarely have an effect on these groups. CMS uses the following criteria to determine if a measure is significantly impacted:
• Coding updates that lead to changes in measure scope or intent will be considered significant changes since such changes could affect the applicability of the historical benchmark
• Clinical guideline changes, new products, or procedures reflected in ICD-10 code updates
• Coding updates due to feedback received from measure developers and stewards
APS will work with our registry partners to coordinate data submission in line with CMS guidance.
2024 Final Scores and Payment Adjustments
There was a delay in release of the 2024 final MIPS scores this year due to an issue with Medicare claims data needed to calculate cost measures. Final scores were posted to the QPP accounts on September 9th, but without the payment adjustment information for 2026 claims. CMS did get payment adjustments posted to the QPP accounts on October 15th.
APS will compile the complete picture of MIPS results for 2024, including payment adjustments for 2026, and communicate with our clients as soon as possible.
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