• E-mail
• Print
• RSS

Improve discharge disposition compliance

HIM Connection, January 13, 2004

Want to receive articles like this one in your inbox? Subscribe to HIM Connection!

Already under an Office of Inspector General (OIG) agreement for physician billing problems and facing a dramatic increase in the diagnosis-related groups (DRGs) included in the OIG's postacute transfer policy, the Medical University of South Carolina, in Charleston, recently took steps to increase its discharge disposition coding compliance.

Christine Lewis, RHIA, director of health information services, just updated the facility's discharge order form. It now lists the possible dispositions in a hierarchy based on their effect on the DRG. The further down the list, the more important the disposition is to the DRG, she explains. This way the abstractor knows the further down the list, the more significant to affecting the DRG." The abstractor assigns the discharge disposition, which is verified by the coder and the outcome manager, who arranges most discharge plans. Lewis receives an e-mail if the dispositions don't match.

Sometimes, the records have conflicting information, making it difficult for the abstractor to choose the appropriate disposition, Lewis says. "We try to encourage and educate through our outcome managers and through physician education that the disposition is very important to mark appropriately. If they discharge to home health services, we want them to circle [physical therapy and occupational therapy] or social work. Our physicians, I think, are trying to be as specific as possible in marking the disposition codes."

As part of the OIG agreement, the agency selects five DRGs on the hospital side to audit each year in addition to the physician billing. "Our compliance officer says she couldn't have been happier because she knows our coding division is very conscientious. We know the disposition is important. We know the coding guidelines and practices are important. We're in year three with no errors," says Lewis.

This week's excerpt is from Medical Records Briefing, a monthly publication for HIM professionals. Click here for more information or to order.

Check out the Editor's Choice section below for solutions to your records completion problems.

Kate Alvarez
Editorial Assistant
kalvarez@hcpro.com

Want to receive articles like this one in your inbox? Subscribe to HIM Connection!

• E-mail to a Colleague
• Print
• RSS
• Archive