Health Information Management

2012 IPPS proposed rule: What you need to know

HIM-HIPAA Insider, June 14, 2011

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CMS has released its fiscal year (FY) 2012 IPPS proposed rule, and coders need to note various changes. Here are some highlights.

Documentation and coding adjustment. CMS proposes implementing a -3.15% documentation and coding adjustment (DCA) in 2012 with an additional -0.75% DCA in the future to accomplish an overall 3.9% adjustment in accordance with statutory requirements. CMS did not propose a timeline for the 0.75% adjustment.
 
How to prepare: The DCA is inevitable, so implementing a robust clinical documentation improvement (CDI) program is the best way to prepare, says James S. Kennedy, MD, CCS, managing director at FTI Healthcare in Atlanta. "Hospitals need to make sure that at the end of the day, the record speaks for itself and that the codes are clinically congruent and supported by provider documentation," Kennedy says.
 
CDI is the key to success, says Laura Legg, RHIT, CCS, revenue control coding consultant at Providence Health & Services in Renton, WA. There's no time like the present to focus on increased accuracy of CC/MCC capture and compliant assignment of principal diagnosis, Legg says.
 
Editor’s note: To read more, access this article in the June issue of Briefings on Coding Compliance Strategies.



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