Health Information Management

Use PEPPER reports to stay on top of common coding errors

HIM-HIPAA Insider, February 9, 2010

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HIM directors can evaluate their hospital’s potential risk for overcoding and unnecessary admissions by using PEPPER data. “Many hospitals use PEPPER data to identify areas for quality improvement and prepare for greater Medicare oversight by auditors such as RACs,” the American Hospital Association states.
 
“It really is helpful to know what [the government] is looking at, so we can look at the same thing here,” says Susan Donahoo, RHIA, HIM director at Providence Health Center in Waco, TX.
 
Multiple departments in Donahoo’s hospital take advantage of the information the reports provide. The HIM staff members use them for education, for example. “If we’re really out there with one diagnosis, we definitely want to make sure we’re not missing something and coding something we shouldn’t have,” she says.
 
HIM directors can also use the information to educate physicians on issues relating to documentation. Donahoo’s clinical documentation improvement (CDI) team uses the information for this purpose. If the hospital is high for sepsis, for example, the CDI team members educate their physicians on appropriate documentation in that area.
 
Editor’s note: For more tips, view the February 2010 issue of Medical Records Briefing.



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