All Entries Tagged With: "post-acute care transfer policy"
Mass adjustment to post-acute transfer cases assigned to MS-DRG 956
On May 8, 2009, CMS released transmittal R492OTN. This transmittal instructed Part A contractors (Fiscal Intermediaries and Medicare Administrative Contractors [FIs/MACs]) to download the revised FY 2009 IPPS Pricer and to mass adjust claims that meet the following criteria:
- Have a discharge date on or after October 1, 2008;
- Were assigned to MS-DRG 956; and
- Were assigned a transfer Price Return Code of ‘10’.
Hospital compliance with Medicare’s post acute transfer rules
At the end of February, the DHHS Office of Inspector General (OIG) released a report on hospitals’ compliance with Medicare’s post acute transfer policy. In that report, the OIG estimated that certain hospitals improperly coded 15,051 claims and that, as a result, Medicare overpaid $24.8 million to these hospitals for the three-year period that ended September 30, 2005. The OIG included post acute transfers as an area of focus in its FY 2008 Work Plan. In that Work Plan, the OIG indicated that it would examine hospitals’ control systems to see whether they accurately coded patients’ status at the time of discharge when those patients were being discharged to certain post acute settings, rather than to their homes. [more]
