News: PEPPER released for short-term acute care hospitals

CDI Strategies - Volume 11, Issue 12

TMF Health Quality Institute released a new Program for Evaluating Payment Patterns Electronic Report (PEPPER) for short-term acute care hospitals for the fourth quarter of fiscal year (FY) 2016.

The Office of Inspector General (OIG) encourages hospitals and providers to review the report and develop compliance programs to avoid improper payments, fraud, and abuse, according to the release from CMS.

Each PEPPER release summarizes data statistics from specific hospitals for MS-DRGs and discharges at risk for improper payments. The new PEPPER report includes the following revisions:

  • “Same day” or “one-day” stays for medical and surgical DRGs
  • One- and two-day target areas exclude claims with occurrence span code 72 with “through” date on or day prior to inpatient admission

To learn more about PEPPER and how to leverage the reports for supporting revenue integrity and reducing risk, consider attending this webinar on April 11.

Editor’s note: To read the entire PEPPER release, click here. To read about how best to use PEPPER, click here. For information about using PEPPER to search for CDI targets, click here. To view a presentation about using PEPPER to revitalize your CDI program, click here.

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