Health Information Management

Use PEPPER to improve coding compliance

HIM-HIPAA Insider, May 11, 2010

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Aside from being a catchy acronym, PEPPER (Program for Evaluating Payment Patterns Electronic Report) includes a wealth of information regarding MS-DRG outliers that might otherwise go completely unnoticed.

That was exactly what was happening at Baptist Memorial Health Care Corp. until the 15-hospital health system began using PEPPER in 2003, says Kathy Graham, RN, MSHA, CPHQ, ACM. Graham serves as system director of case management and regulatory affairs specialist.
Data gleaned from the reports not only helped Baptist Memorial monitor MS-DRG volume, it also enhanced coding compliance and served as the impetus to:
  • Provide additional coder education 
  • Implement coding updates developed at the corporate level that are disseminated to coders systemwide
  • Allocate case managers to the ED to enhance early identification of medical necessity and also to help improve documentation 
Note: To read more, visit the HCPro Web site. Subscribers to Briefings on HIPAA have access to this article in the May issue of their newsletters.

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