Q&A: Parsing hospital-acquired pneumonia from hospital-acquired conditions
Q: Why is hospital-acquired pneumonia not considered a CMS hospital-acquired condition (HAC)?
A: This is confusing to a lot of people because of the similarity of terms used. Hospital-acquired pneumonia is a clinical descriptor. However, CMS’ hospital-acquired conditions are more of a payment classification than a clinical classification. Thus, those conditions that are certainly hospital acquired from a clinical perspective may or may not be a CMS hospital-acquired condition.
Hospital-acquired conditions are conditions that CMS has classified as preventable, and thus are not subject to additional payment coverage. At this time, hospital-acquired pneumonia is not considered a HAC by CMS.
Here are some links for further reading:
I hope this helps!
Editor’s note: Allen Frady, RN-BSN, CCDS, CCS, CDI Education Specialist for HCPro in Middleton, Massachusetts, answered this question. Contact him at AFrady@hcpro.com. For information regarding CDI Boot Camps visit http://hcmarketplace.com/clinical-doc-improvement-boot-camp-1.