The fiscal year (FY) 2019 IPPS proposed rule includes updates to payment rates and quality initiatives, but some of the most extensive changes pertain to MCC and CC additions and deletions.
CMS released the fiscal year (FY) 2019 IPPS proposed rule on Tuesday, April 24, with significant reductions to reporting requirements for quality initiatives and expected ICD-10-CM/PCS code and MS-DRG updates.
Systemic inflammatory response syndrome (SIRS) criteria has a greater sensitivity than quick sepsis-related organ failure assessment (qSOFA) as a screening test to initiate treatment for sepsis in non-intensive care unit patients, according to the recent study published in the Annals of Internal Medicine.
Of emergency department visits attributable to ruptured abdominal aortic aneurysm, acute myocardial infarction, stroke, aortic dissection, and subarachnoid hemorrhage, the conditions were not accurately diagnosed approximately one out of 20 times, according to a study by the Journal of the American Medical Association (JAMA) .
An Office of Inspector General (OIG) audit of the University of Michigan Health System revealed noncompliance with four types of inpatient claims, including those associated with the billing of high-severity-level MS-DRGs.
The cost for a hospital stay in 2014 involving acute renal failure (ARF) averaged $19,200, nearly twice the $9,900 average cost for stays not involving renal failure, according to the statistical brief published by The Healthcare Cost and Utilization Project (HCUP).
Hospitals reduced central line-associated bloodstream infections (CLABSI) by 50% between 2008 and 2016, according to a new report released by the Centers for Disease Control and Prevention (CDC).
Only 12% of eligible hospitals signed up for CMS’ Bundled Payments for Care Improvement Model 2 initiative and 47% of them dropped out completely within two years, according to a recent study by the Journal of the American Medical Association .
On January 9, CMS announced the launch of Bundled Payments for Care Improvement Advanced from the agency’s Center for Medicare and Medicaid Innovation.
A report released by the American Hospital Association and Manatt Health found that facilities spend approximately $39 million annually to comply with 629 requirements across nine regulatory domains.
Upon reviewing 2,145 inpatient claims at 25 providers, the Office of Inspector General (OIG) found that all but one claim incorrectly included the ICD-9-CM diagnosis code for kwashiorkor (260). This resulted in overpayments in excess of $6 million, according to the OIG report .
Recent findings support the possibility that the Hospital Readmissions Reduction Program has had the unintended consequence of increased mortality in patients hospitalized with heart failure, says a study published by JAMA .
Inpatient stays involving any opioid-related diagnosis increased by 14.1% after ICD-10-CM was implemented in 2015, according to a study recently published in Medical Care .
On October 4, CMS issued a notice in the Federal Register containing numerous corrections to the 2018 IPPS final rule, including significant recalculations of MS-DRG relative weights and all budget neutrality factors.
While the Affordable Care Act has led to fewer 30-day readmissions, this reduction in readmissions does not correlate with 30-day mortality rates, according to a recent JAMA study.
The Centers for Disease Control and Prevention (CDC), one of the Cooperating Parties responsible for the ICD-10-CM codes and guidelines, recently released a 2018 ICD-10-CM Official Guidelines for Coding and Reporting errata. Slight changes were made to the guidelines for diabetes, hypertension, and principal diagnosis selection.
The fiscal year 2018 IPPS final rule included updates to payment rates and quality initiatives, as well as an ample amount of code changes and updates to ICD-10-PCS non-OR to OR code designations.
Don’t automatically presume a link between two conditions within a combination code in cases when a guideline requires that link to be explicitly documented, the latest version of the ICD-10-CM coding guidelines clarify.
On Wednesday, August 2, CMS released the fiscal year 2018 IPPS final rule which featured updates to various quality initiatives, along with annual payment updates for inpatient services.
