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Callers comment on HACs during special CMS session

Briefings on Coding Compliance Strategies, February 1, 2009

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For more than a year, coders have reported the present-on-admission (POA) indicator for most diagnoses on hospital claims. Effective October 1, 2008, CMS stopped paying for certain hospital-acquired conditions (HAC) that are documented as secondary diagnoses and as not being POA (indicator N) or that include insufficient documentation (indicator U). Since then, CMS has reimbursed as though these secondary diagnoses were not clinically present.

The 2009 IPPS final rule listed the categories of HACs that CMS selected for implementation for fiscal year (FY) 2009. In addition, CMS proposed nine candidate HACs for future consideration. (See the sidebar below for a list.)

On December 18, 2008, CMS and the Centers for Disease Control and Prevention (CDC) held a jointly sponsored daylong session to discuss the selected and candidate HACs, solicit participant comments, answer questions, and discuss the future of the payment provisions. More than 2,000 people, including participants on-site and dialing in via phone, attended the event. 

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