Secrets for becoming a Top 200 Coding Hospital in 2008

Ingenix conducts the Top 200 Coding Hospitals study each year to identify those hospitals that have the most complete and compliant coding operations. This year's report was released on October 9.

Recent online and print issues of Healthcare IT News include articles about the Ingenix Top 200 Coding Hospitals in the U.S. report. The article appeared in the Oct. 8, 2007 online issue of Healthcare IT NewsDay, and a similar article appears in the November 2007 print edition.

“This year’s Top 200 report comes at a pivotal time for the industry as hospitals prepare for Medicare’s transition to a severity-adjusted reimbursement system that will substantially change coding practices,” said Stephen Greenberg, senior vice president in the Provider Solutions Group at Ingenix. “These changes create an additional incentive for hospitals to improve their clinical documentation and coding efforts, as the hospitals that code more completely could get a larger share of the reimbursement pool than those that continue to code based on today’s Medicare reimbursement rules.”

As Steve implied, it's going to be easier to be a top coding hospital in 2007 than in 2008.

Currently, the top hospitals do two things well:

• They look for opportunities to code to a higher case mix in areas where services are provided
• They avoid coding with DRGs that have a high compliance risk, thus decreasing their risk of an OIG audit

Now that CMS has adopted DRG version 25, Medicare Severity DRGs, HIM departments' jobs will get more complicated. In addition to paying attention to case mix and high risk DRGs, they'll need to demonstrate excellence in Present on Admission coding, in coding CCs and MCCs correctly, and avoiding DRGs that may trigger a Recovery Audit.