The fiscal year (FY) 2017 IPPS proposed rule included some significant changes to Patient Safety Indicator (PSI) 90, one of which is a new name: The Patient Safety and Adverse Events Composite. A fact sheet recently released by the measure's owner, the Agency for Healthcare Research and Quality...Read More »
Q: I am with a CDI program that is starting to explore the severity of illness/risk of mortality (SOI/ROM). I personally have been reviewing for SOI/ROM for quite a while. I usually designate the impact (MCC/CC/SOI/ROM) after the billing is done and see if what I queried for...Read More »
One size does NOT fit all when it comes to health insurance. Beneficiaries range from the extremely healthy 65-year-old—the poster child for “65 is the new 45”—to a 65-year old suffering from COPD from a lifetime of smoking, cancer, and a hereditary condition such as Type 1 diabetes. The result...Read More »
The American Hospital Association (AHA) is concerned about the documentation and coding reduction, changes to disproportionate share hospital (DSH) payments, and the implementation of many of CMS’s quality programs detailed in the CMS IPPS Proposed Rule for Fiscal Year (FY) 2017, according to a ...Read More »
Recovery Auditor medical record requests and automated and complex denials all fell slightly in the first quarter of 2016, as did the average number of medical record requests per hospital, which decreased slightly since the fourth quarter of 2015, according to the latest RACTrac report...Read More »
CMS issued a final rule last week to revamp the way it pays for tests under the Clinical Laboratory Fee Schedule (CLFS). Now starting January 1, 2018, CMS will base CLFS payments on the weighted median amount paid by private payers for the same services. Providers are hopeful that these new...Read More »
Q: The coders at my facility have stated auto linking congestive heart failure (CHF), hypertension (HTN), and chronic kidney disease (CKD) to the combination code without any documentation of CHF “due to” HTN. There is no documentation of hypertensive heart disease anywhere in...Read More »
Editor’s Note: Over the coming weeks on the ACDIS Blog, we’ll introduce a few of this year’s speakers who are heading to the podium for the...Read More »