This week’s updates include change requests regarding payments to home health agencies that do not submit required quality data; the July 2016 update of the ambulatory surgical center payment system; and more!
Q: CMS released guidance last summer about not auditing or counting errors for the specificity of an ICD-10-CM code. CMS is not going to count the code as an error as long as the first three digits are correct. Does this apply to medical necessity diagnoses and edits?
The healthcare industry is focused on the triple aim: reducing healthcare costs, improving patient experience, and improving the health outcomes of populations. Healthcare organizations will no longer be paid based on the volume of services provided but rather on the value of care delivery.
Those who regularly attend the annual AHIMA Convention and Exhibit no doubt have seen the exceptional quilt created each year by AHIMA member Katy Sheehy, MPA, RHIA, and sponsored by the Dames of Distinction to be bid at auction. The quilt is auctioned in support of the Linda Culp Memorial Scholarship fund, which was established in memory of the late Linda Culp, a former HIM professional, hospital chief executive officer, and AHIMA member. If you have seen the quilt, you have probably asked yourself, "Who are these people?"
Creating and conducting an organizationwide risk analysis: Part 1
Editor's note: This is part one of a series about implementing organizationwide risk analyses. Look for part two in an upcoming issue of BOH.
OCR's breach settlements, corrective action plans (CAP), and penalties often take organizations to task for not completing a regular organizationwide risk analysis, yet it's all too easy for this important job to fall by the wayside. A lack of resources and competing demands within an organization can push the risk analysis to the bottom of the list of priorities. But this leaves an organization vulnerable to threats it will only see in hindsight. It also often leads to scrutiny from OCR and the public.
