My analytical side is always harassing me to get it more involved in what I do. So I decided to dig into our hospital’s PEPPERs. PEPPER is the Program for Evaluating Payment Patterns Electronic Report, issued quarterly. (Calling it a...Read More »
The Medicare Learning Network released three fact sheets of interest to CDI staff:
The “Hospital Acquired Conditions (HAC) in Acute Inpatient Prospective Payment System (IPPS) Hospitals” fact sheet (revised October 2010) is now available in downloadable format at
The Hospital Compare website, updated on Dec. 11, contains three new inpatient measures. These include Surgical Care Improvement Project (SCIP) Infection 9 (urinary catheter removed on postoperative day one or two) and two new structural measures: participation in a systematic clinical data...Read More »
When evaluating overall compliance within a CDI department, Lynne Spryszak, RN, CCDS, CPC-A, CDI education director for HCPro, Inc., in Danvers, MA, says that CDI department managers should:
Try not to confine your reviews to a particular payer. Although everyone
The Department of Justice (DOJ) recovered $2.5 billion in healthcare fraud recoveries for fiscal year (FY) 2010—the largest in history—and $3 billion in total civil fraud claims, according to a DOJ press release. Of that...Read More »
CMS has modified the additional documentation request (ADR) limits (i.e., medical record request limits) for the RAC program in 2011, according to document posted November 10 on the...Read More »
On October 14, we reported that CMS issued a controversial MLN Matters special edition (SE) article which stated that all inpatient admissions needed to have any/all ‘other’ or ‘secondary’ diagnoses documented by the attending physician.
