The good news is that the rate of 30-day readmissions is going down in hospitals across the nation, according to a CMS report. The bad news is that fines are going up. CMS also added some new conditions to its readmission prevention list for 2015.
In October 2014 a record number of hospitals were fined for excessive care transitions. In total, CMS penalized some 2,610 hospitals, and will assess fines between October 2014 and September of this year. Through these penalties, the government has given hospitals sufficient incentive to revamp their processes with an eye on preventing readmissions and improving transitions.
Even before ICD-10-CM was delayed until October 1, 2015, the quality of physician documentation to accommodate the new code set was a top concern for the healthcare industry.
A lot can go wrong when an elderly patient is discharged home, from medication errors to transportation problems or self-care comprehension issues. However, an organization can create a solid discharge and transition process by focusing on some simple elements.
Organizations often struggle to finalize charts after discharge so they can be coded in a timely manner, but this process can be completed efficiently with direction from HIM professionals and coordination between departments.
Inpatient coding professionals are used to DRG systems where all of the diagnoses and procedures map to a single DRG. So they may not look for additional procedures and services to report outside of that DRG.
