Case Management

Tip: Hospital and discharge planner responsibilities for transfer MS-DRGs

Case Management Weekly, April 6, 2011

Hospital are responsible for ensuring that:

  • Patients have a safe discharge plan
  • Discharge plans meet the requirements of the Social Security Act
  • Patients’ freedom of choice during the discharge process
  • Discharge plans are based on the assessed continuing-care needs of individual patients

Discharge planners are in a unique position to ensure accurate documentation of patients’ disposition status at the time of discharge. The disposition code affects payment to the hospital. Any pattern of coding inaccuracies, particularly where inaccurate coding can lead to a full MS-DRG payment when a transfer MS-DRG rate should be paid, may be viewed as fraudulent.

This week’s tip is adapted from Discharge Planning Guide: Tools for Compliance, Third Edition published by HCPro, Inc. For more information about this book or to order your copy, visit the HCMarketplace

Do you have a question about a case management topic? Send it to Associate Editor Ben Amirault at bamirault@hcpro.com. An answer to your question might appear in a future issue of Case Management Weekly.

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