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.
Realizing that the go-live date won’t change, some facilities already have organization-wide ICD-10 implementation strategies in place. If your CDI program hasn’t yet been involved in ICD-10 discussions or if your facility hasn’t starting the planning process yet, consider incorporating elements...Read More »
There may be hope for hospitals carefully watching the proposed IPPS rule, praying for some amelioration of the suggested 2.9% documentation and coding adjustment (DCA) it included. On July 12, 242 members of Congress...Read More »
A special edition MLN Matters article released last week points to two common reasons for RAC claims denials—lack of timely submission of requested documentation and lack of documentation supporting medical...Read More »
The Program for Evaluating Payment Patterns Electronic Report (PEPPER) includes a wealth of information regarding MS-DRG outliers that might otherwise go completely unnoticed. That’s what happened at Baptist Memorial Health Care Corp. until the 15-hospital health system began analyzing its...Read More »
Despite the inclination of many hospital administrators to mechanize documentation and abstraction of quality measures, Kristen Geissler, MS, PT, MBA, CPHQ, associate director in the Healthcare Clinical Economics Practice at Navigant Consulting, Inc., in Baltimore, hasn’t heard of anyone able to...Read More »
