Health Information Management

News: ACDIS, AHA comment to CMS on FY 2012 IPPS final rule

CDI Strategies, June 23, 2011

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ACDIS submitted comments to CMS regarding recent updates to the ICD-9-CM codes not included in the FY 2012 IPPS rule. You can view the codes on the Centers for Disease Control and Prevention website.

The bulk of ACDIS’ comments concern the collective opinion of the board as to how these new codes should be paid, including their CC/MCC status. ACDIS members can read the complete comments in the CDI Journal. 
 
In its comments, the American Hospital Association (AHA) asked CMS to reduce the proposed documentation and coding offset included in the proposed Inpatient Prospective Payment System (IPPS) proposed rule. CMS accepted comments on the rule through this past Monday, June 20. The proposed offset would cut hospital payments by 6.05%, or $6.3 billion, and create substantial volatility in IPPS rates, AHA said. Changes included in the IPPS and elsewhere in recent healthcare policies would result in an overall decrease in fiscal year (FY) 2012 payments to hospitals by nearly $500 million as compared to FY 2011.
 
According to an article in AHA News, the association believes CMS’ erroneously blames cost increases on documentation and coding changes due to the implementation of the MS-DRG system in 2008 instead of the legitimate escalation of increases in the case-mix index.
 
Thus, CMS' proposed cut “is excessive in light of these historical trends in CMI change and should not be implemented," AHA said in its letter to CMS.
 
The AHA also expressed its concerns about the Hospital Readmission Reduction Program, urging CMS to conduct a study to determine reasons for planned readmissions, and to take steps to improve the existing measures, according to AHA News.



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