All Entries Tagged With: "POA"
New modifiers for outpatient never events; billing for hospital-acquired conditions
This week, CMS published the July Integrated Outpatient Code Editor (I/OCE). Although there were relatively few changes, CMS did introduce three new modifiers for use with the occurrence of three never events identified by the National Quality Forum (NQF) that were recently the subject of National Coverage Analyses by CMS. The new modifiers are: PA for surgical or invasive procedure on the wrong body part, PB for surgical or invasive procedure on the wrong patient, and PC for wrong surgery or invasive procedure on patient. The modifiers were added to the list of valid modifiers effective January 1, 2009.
Proposed FY 2010 IPPS Rule – An overview
On Friday May 1, CMS released the proposed inpatient prospective payment system (IPPS) rule for FY 2010. Hospitals, including long-term-care hospitals (LTCs) and certain other non-IPPS hospitals (e.g., CAHs), are encouraged to review the proposed rule and to provide written comments to CMS by 5:00 p.m. E.S.T. on June 30, 2009. [more]
CMS issues guidance on the effect of POA indicators for HACs
CMS issued a Special Edition MLN Matters article last week on the present-on-admission indicator. In the article, there are references for coding guidance in the UB-04 Data Specifications Manual and the ICD-9-CM Official Guidelines for Coding and Reporting.
CMS also discussed how each one of the indicators will be treated for payment purposes. If a particular hospital-acquired condition is reported with an “N” (for not present on admission) or a “U” (for “documentation insufficient to determine if the condition was present at the time of admission”), the diagnosis will not be considered a complication or comorbidity (CC) or major CC for the purpose of DRG assignment. [more]
