When hospitals appeal their denials they typically win. The AHA's RACTrac report indicates that hospitals appeal more than 40% of their denials with a roughly 75% success rate.
That’s where CDI professionals come in.Read More »
Malnutrition codes proposed for CC status; 584.8 for downgrade
Inpatient acute care hospitals could see a 2.3% increase in payment rates under the fiscal year (FY) 2013 inpatient prospective payment system (IPPS) proposed rule, released April 24. The 2.3% is a...Read More »
Documentation in today’s records may affect payments in FY 2014, 2015
Fail to reduce costs or fail to meet quality measures and your facility could lose out on those incentive payments—a loss of up to 1% of all MS-DRG payments in FY 2013, and up to 2% by 2017. In July, CMS...Read More »
Editor’s note: The following is an excerpt from ACDIS’ letter to CMS regarding the inpatient prospective payment system (IPPS) proposed rule for fiscal year (FY) 2013, sent on June 11, 2012. ACDIS is pleased to comment on the proposed changes to the Medicare Hospital...Read More »
Q: I was interested in further discussion about cystic fibrosis coding. I am conducting an audit on MS-DRGs 177, 178, and 179, Respiration infections and inflammation with MCC...Read More »
CMS recently published a draft ICD-10 MS-DRG definitions. According to the website, the definitions are displayed in 'grouper logic order,' meaning that the MS-DRGs are listed in the order in which the grouper recognizes them. “This enables users to see instances where grouper logic order...Read More »
An emergency department (ED) physician diagnosed a patient with pneumonia. He was concerned about a possible nosocomial etiology given the patient’s recent hospital discharge for problems related to atrial fibrillation. Because the patient’s Pneumonia...Read More »
MLN Matters article SE1121 emphasizes that coders must consider all documentation from licensed treating physicians and attending physicians when assigning a principal diagnosis. It states:
“The emergency room report, history and physical (H&P),...Read More »
