Inpatient or observation? Making this decision remains a considerable challenge at many hospitals—and when they get it wrong, it can also be a costly one.
It’s always been easy to show financial return on investment for inpatient CDI endeavors, but the monetary value of outpatient programs is increasing dramatically year after year, making outpatient CDI reviews more attractive to many healthcare organizations.
If your organization is not already screening short inpatient stays, now may be a good time to start, says Ronald Hirsch, MD, FACP, CHCQM, CHRI, a vice president at R1 RCM Inc. in Chicago.
The fiscal year (FY) 2022 Inpatient Prospective Payment System (IPPS) proposed rule makes broad efforts to cushion the ongoing impact of the COVID-19 pandemic on hospital revenue and resources. The proposed rule, released April 27, also eliminates sweeping changes to MS-DRG rate-setting finalized in the 2021 IPPS final rule.
The widespread adoption of electronic medical records and software has made it easier for coders to ensure that all necessary query elements are present. Nonetheless, coders must understand what these elements are.
