Oct. 1 marks the beginning of the fiscal year for the Centers for Medicare & Medicaid Services. This milestone does not include the changes in Medicare payments that occur with the implementation of new rules, CPT codes, or changes in the fee schedule. Those changes begin on Jan. 1 of each year, and we will once again provide you with updates in November once the final rule is published. Oct. 1 does, however, mark the new year for ICD-10.

When I was a physician advisor, I used to offer a diabetic Charcot joint as an example of why we must be explicit with linkage. Years ago, if a provider listed diabetes mellitus and a Charcot joint (neuropathic osteoarthropathy) as concomitant diagnoses without documenting clear linkage, the encoder would lead a coder to a syphilitic Charcot joint. I used to joke with my audiences that this would be quite a revelation to patients and their family members, in this day and age of medical record transparency.