Health Information Management

Don't let improper discharge disposition codes fly under the radar at your facility

HIM-HIPAA Insider, June 15, 2010

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You may think the discharge disposition codes you assign are correct, but discharge plans often change after patients leave the hospital. Discharge codes should reflect those changes, particularly when compliance ramifications—and dollars—are at stake.

Hospitals could inadvertently leave money on the table when cases fall into MS-DRGs subject to the Post Acute Care Transfer (PACT) policy, says William E. Haik, MD, director of DRG Review, Inc., in Fort Walton Beach, FL. The PACT policy reduces hospital payments to a per diem rather than a full DRG amount when patients are discharged to certain post-acute care settings.
 
Many hospitals don’t follow up with patients post-discharge and simply assume the per diem payment is correct, says Haik. During retrospective audits, he often finds significant underpayments due to incorrect assignments of discharge disposition codes that trigger the PACT policy. “There’s a myriad of pitfalls where the hospital can be adversely affected financially with this payment methodology,” he says.
 
Note: To read more, visit the HCPro website. Subscribers to Briefings on Coding Compliance Strategies have access to this article in the June issue of their newsletters.



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