In a recent HCPro audio conference titled “ Observation Services v. Inpatient Admission: Assign Proper Level of Care and Prevent Denials,” experts answered listeners’ questions about proper use of observation services.
In an effort to enhance outcomes and standardize practice in pediatric patients, Children’s Hospital and Medical Center created three sets of clinical protocols for three of the hospital’s high-volume DRGs.
As the Patient Protection and Affordable Care Act implementation progresses, the quality and outcomes of care face increasing public scrutiny. Policymakers will determine our complication rates and publicize them on the Internet, influencing public perception of our competencies and quality. Don’t believe me? Read in the Atlanta Journal-Constitution about some Georgia hospitals’ “high” pneumonia, heart failure, and myocardial infarction mortality (http://tinyurl.com/GA-mortality). See your own cost efficiency and quality profile on United Healthcare’s website (www.uhc.com) under the “Find a Physician” tab. Where is information to make these determinations obtained? It’s from ICD-9-CM codes assigned by our hospitals based upon documentation. Consequently, we have a vested interest in ensuring that complication codes are submitted accurately.
In what was perhaps an effort to remind providers to consider medical record retention as they move to EHRs, CMS released MLN Matters SE1022, which addresses medical record retention limits and media formats.
