The auditing arm of the Department of Health and Human Services (HHS) plans to crack down on hospital performance in the areas of reporting of adverse events and quality measure data, present on admission coding, inpatient outlier payments, and same-day readmissions.
On October 20, CMS released its long-awaited final rule governing accountable care organizations (ACO), with major concessions to the original plan that had soured many healthcare leaders and physicians against participating....Read More »
Coders and CDI specialists need to understand the implications coding and sequencing may have on readmissions data and cohort selection, says James S. Kennedy, MD, CCS, managing director at FTI Consulting in Atlanta and a member of the ACDIS advisory board.
Documentation improvement staff often struggle with principal diagnosis selection. A clear understanding of the definition of principal diagnosis and the factors that play into principal diagnosis selection is extremely important, although often confusing.
The quarterly reports issued by the Program for Evaluating Payment Patterns Electronic Report (PEPPER)contain large amounts of data on how a facility compares to others in the same state, the same jurisdiction (i.e., the same Medicare Administrative Contractor), and nationwide in terms of coding...Read More »
