Health Information Management

Understand inpatient wound care coding for RAC audits

HIM-HIPAA Insider, May 12, 2009

Want to receive articles like this one in your inbox? Subscribe to HIM-HIPAA Insider!

During the three-year RAC demonstration project, payment for several inpatient debridement procedures under DRGs 263 and 217 (from the old DRG system, not MS-DRGs) resulted in a combined $18 million in overpayments to hospitals, a hefty sum for noncompliant hospitals to pay back.

Nationwide rollout of the RAC program is already underway. It expanded to 24 states in March, and the rest of the country could see auditors as early as August 1. One question on everyone’s minds is whether inpatient wound care will continue to be a hot-button issue when the permanent RACs come knocking.

It’s difficult to know for sure, but Gloryanne Bryant, BS, RHIA, RHIT, CCS, senior corporate director of coding and HIM compliance at Catholic Healthcare West in San Francisco, said it’s a strong possibility.

Editor’s note: To read more about inpatient wound care coding or to purchase a copy of this article for $10, visit the HCPro Web site. Subscribers to Briefings on Coding Compliance Strategies have access to this article in the May issue.



Want to receive articles like this one in your inbox? Subscribe to HIM-HIPAA Insider!

Most Popular