Numerous coding changes take effect Oct. 1, 2008. Are you and your organization prepared? Several MS-DRGs will be modified as of Oct. 1. In addition, there are many additions and deletions to the exclusion list, as well as changes to CCs and MCCs.

One Yahoo newsgroup, the Hospital Inpatient Coders group, recently posted a checklist for coders to reference as they prepare for Oct. 1. The post contains links to numerous resources, and can be accessed here. Free registration is required to access the group.
More....

The increasing complexity of CMS data mining tools to monitor compliance and overpayments should encourage hospitals to develop their own data mining initiatives, according to an article in the Sept. 29, 2008 issue of Report on Medicare Compliance.

The article describes three factors that are increasing the need for hospitals to create their own data mining efforts:
More....

Forty percent of health information management (HIM) directors at hospitals anticipate that their organizations will owe money to Medicare due to overpayments following an audit conducted by the Recovery Audit Contractor (RAC) program.

This is one of many findings revealed in a survey of hospital HIM directors conducted by Wolters Kluwer Health. The survey also revealed that:
More....

CMS has added new documents to its Recovery Audit Contractor (RAC) website that provide additional details about the expansion of the program.

CMS plans to have a nationwide RAC program in place by Jan. 1, 2010, which will be managed by four independent RACs. CMS plans to have the program's contractors in place by early 2009, but not operational until Jan. 1, 2010.
More....

On Sept. 4, CMS launched an updated version of its present on admission (POA) and hospital-acquired condition (HAC) website. The updates describe the changes to POA and HAC reporting requirements that were published in the FY2009 Inpatient Prospective Payment System (IPPS) final rule. Access the updated site here.

The FY 2009 IPPS final rule applies to discharges on or after Oct. 1, 2008. The updated site directs visitors to numerous resources that have been indexed in recent months. Additions to the site include:
More....

The American Hospital Association (AHA) sent a letter to CMS asking for further clarification on its no-pay policy for hospital-acquired conditions (HACs) and never events. Specifically, the AHA asked CMS to clarify:

• How are the events defined?
• How will accountability for the event be assigned?
• What costs or services should not be covered?

AHA’s concern is that there are scenarios where it may be difficult to interpret when the CMS no-pay regulations apply. AHA outlined several such scenarios in its letter, such as:
More....