Coding 3 common pediatric eye conditions with ICD-10-CM.
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Tag Archives: Focus
SHEA urges increased focus on preventing superbugs
Progress against methicillin-resistant Staphylococcus aureus (MRSA) infections has slowed in hospitals, while methicillin-susceptible Staphylococcus aureus (MSSA) is increasing in communities.
Focus on Documentation to Improve Proper Payments for Lenses
Insufficient documentation accounted for more than 77 percent of the 85.2 percent improper payment rate for lenses during last year’s reporting period, according to the 2018 Medicare Fee-for-Service (FFS) Supplemental Improper Payment Data. You can help reduce this staggering error rate by being aware of the national and local coverage policies physicians and non-physician practitioners […]
The post Focus on Documentation to Improve Proper Payments for Lenses appeared first on AAPC Knowledge Center.
Joint Commission surveyor focus remains on EC, LS, ligature risks
Some of the top takeaways for environment of care and other healthcare and quality professionals attending The Joint Commission’s (TJC) annual Hospital Executive Briefings held September 14 in New York City.
CMS seeks billing specialists to participate in provider compliance focus group
Has your CDI program shifted its focus for optimal PSI 15 performance?
Has your CDI program shifted its focus for optimal PSI 15 performance?
by Shannon Newell, RHIA, CCS, and AHIMA-approved ICD-10-CM/PCS trainer
The recent adoption of a refined version of the Patient Safety Indicator (PSI) 90 composite by the Agency forHealthcare Research and Quality (AHRQ) has a significant impact on what discharges are included in PSI 15 (Unrecognized Abdominopelvic Accidental Puncture Laceration Rate).
Your clinical documentation improvement (CDI) program has likely focused on this measure due to the well-established challenges associated with accurate reporting of procedure-related accidental puncture/lacerations. Given the changes to PSI 15, should your CDI team shift its focus to promote and support accurate data integrity for this measure? Let’s take a look.
A fundamental understanding of patient safety indicator measures
Optimal data integrity for PSIs requires that we have the appropriate clinical documentation and reported ICD-10 codes to accurately reflect the following:
- The numerator: The numerator for PSI 15, also called the "outcome of interest," reports the actual number of cases which experienced the accidental puncture/laceration.
- The denominator: The denominator for PSI 15, also called the "cohort," establishes the population which is screened to identify the outcome of interest.
- Risk adjustment: Denominator comorbidities, which have a statistically demonstrated impact on the likelihood of a patient incurring the patient safety event. The risk adjustment methodology establishes the expected number of discharges with the outcomes of interest.
The inputs above?numerator, denominator, risk adjustment?are used to calculate our observed over expected performance. CMS compares our performance to that reported by other hospitals, and our reimbursement may be then impacted if we do not appear to manage patients well.
For example, in the Hospital Acquired Condition Reduction program, if our performance for PSI 90 does not meet established thresholds, then our Medicare fee-for-service reimbursement is reduced by 1% the next CMS fiscal year (October 1?September 30) for every claim we submit.
The new PSI 15?what counts?
The revised measure specifications for PSI 15 have altered the numerator (outcome of interest). The denominator, or cohort?which represents the population at risk?has also undergone a noteworthy change).
The revised numerator and denominator greatly narrow the pool of discharges screened for accidental punctures or lacerations as well as those flagged with outcomes of interest.
From a CDI perspective, the likelihood of incorrectly reporting accidental puncture or laceration for the discharges included in the newly defined measure is greatly diminished.
PSI 15: Are you focused on risk adjustment?
Given that our performance for PSI 15 is assessed using our observed over expected rate of procedure related accidental puncture or lacerations, the CDI team’s focus may be better spent on strengthening the capture of comorbidities relevant to risk adjustment.
The AHRQ risk adjustment methodology looks for multiple comorbidities to calculate the predicted likelihood of accidental punctures/lacerations for each discharge.
The revision to the discharges included in the narrowed cohort has also impacted which comorbidities affect risk adjustment. This makes sense given that these comorbidities must be clinically relevant to the numerator and denominator. The number of comorbid categories has been reduced from 13 to 11. Some of the categories remain the same, some have been deleted, and new ones have been added.
Summary
Keeping abreast of revisions to claims-based measures is an expanded responsibility for today’s CDI program. These measures impact both reimbursement and quality profiles. Positioned with this information, the CDI program can then shift efforts to promote and support clinical documentation capture and accurate reporting of codes associated with areas of the greatest vulnerability and impact.
Editor’s note:
Newell is the director of CDI quality initiatives for Enjoin. She has extensive operational and consulting expertise in coding and clinical documentation improvement, performance improvement, case management, and health information management. You can reach Newell at (704) 931-8537 or [email protected]. Opinions expressed are that of the author and do not represent HCPro or ACDIS.
Dimcogray Forms Dg Medical To Focus On Medical Device Manufacturing
DimcoGray of Centerville, Ohio, one of the leading industrial knob and handle manufacturers, has recently created a medical division within the company called DG Medical.
DimcoGray uses customized thermoplastic molding techniques to produce a multitude of different styles of handles and knobs, including electronic knobs and instrument knobs. Additionally, DimcoGray has been serving the medical device industry for over 30 years. With this in mind, the company decided to create DG Medical, a division which makes the medical side an area of complete focus.
DimcoGray supplies the worlds leading medical device manufacturers with high-quality and ergonomically sound medical equipment knobs and handles. These items are customized and molded as specified by the customer. One of the goals of DG medical is to be a resource to medical device companies, whether they choose to outsource some or all of their manufacturing needs.
Specializing in Medical Equipment
DimcoGray has worked with some of the medical device industry’s top original equipment manufacturers (OEMs), providing them with superior products and service. The type of medical equipment parts DimcoGray offers through DG Medical includes:
Drug delivery systems
Monitoring systems
Hospital beds
Operating room equipment
Carts, stands and fixtures
DG Medical possesses the equipment and experience required to meet just about any customer need. DG Medical has the capability to plan and manage the entire product lifecycle; from production and assembly to packaging and shipping. DG Medical is also very responsive and sensitive to customer timelines, including delivery times and schedules.
Reputation and High Standards Keep Customers Coming Back
Assuring medical device companies that products are manufactured in a controlled and sterilized environment is essential. To this end, DimcoGray has built a large Class 10,000 clean room within its existing facility for medical device production. The clean room is certified to ISO 7, which dictates that such a space be virtually free of contaminants such as dust or bacteria.
Speaking of ISO standards, DG Medical has received ISO 13485:2003 certification. This confirms the company consistently meets all regulatory requirements that apply to the manufacture of medical devices and related products and services. It additionally confirms DG Medical has developed the proper controls and oversight to meet or surpass all established ISO standards.
DG Medical is committed to establishing themselves as one of the top contract manufacturers in the medical device industry. Fortified by the experience of parent company DimcoGray, they have a very good head start.
Mike Sieron, President & CEO of DimcoGray Corporation, is the author of this article on industrial knobs and handles, medical equipment handles, and medical equipment knobs. DimcoGray is a Centerville, Ohio company specializing in the supply of commercial knobs and handles that are customized to fit the customers needs.
Coding: Focus on Patient, Not on Payment
Ten plus years and counting and accuracy in Evaluation and Management coding can still be troublesome and evasive. The initial guidelines in 1995 had some ambiguity in the examination component and this was clarified and strengthened in the 1997 guidelines, but the complexity of the bullet point counting system seemed perplexing to many physicians and […]
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