This week’s Medicare updates include a Special Edition MLN Matters article on the new documentation requirements for cost reports, revised manual instructions related to the implementation of the Patient-Driven Groupings Model, an OIG review of the impact of price substitutions based on average sales price data, and more!
The Office of Inspector General (OIG) will review Medicare’s diagnosis-related group (DRG) window policy to determine whether the program could save money by expanding the policy to include more days, according to an update to the OIG Work Plan.
Once enforcement of Medicare’s Hospital Readmissions Reduction Program (HRRP) began in 2012, initial data showed hospital readmissions within 30 days of discharge declined for Medicare recipients admitted to hospitals for certain medical conditions. But according to a new study published in The BMJ, the decrease in inpatient readmissions was outpaced by an increase in overall hospital revisits, creating questions about the overall success of the HRRP.
Q: What would be reported as the principal diagnosis if a patient was admitted with both a urinary tract infection (UTI) and sepsis? What would be reported first if the patient developed a catheter-associated UTI with sepsis?
