News: PEPPER ready for review
CDI Strategies, March 1, 2012
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The fourth quarter 2011 Short-Term Acute Care Program for Evaluating Payment Patterns Electronic Report (PEPPER) is available via QualityNet. This PEPPER release suppresses data regarding “PTCA with Stent” statistics due to problems in the national Medicare claims data warehouse and includes a new target area, “Spinal Fusions.”
The PEPPER provides hospital-specific data statistics for Medicare discharges in 30 areas that may be at risk for improper Medicare payments. Hospitals can use PEPPER to support internal auditing and monitoring activities. CDI specialists should contact their QualityNet administrator for access to the PEPPER and review the report to help target record reviews.
PEPPER is a free report comparing a hospital’s Medicare billing practices with other hospitals in the state, Medicare Administrative Contractor (MAC) or Fiscal Intermediary (FI) jurisdiction, and nation. CMS has contracted with TMF Health Quality Institute to develop and distribute the reports.
For additional information, review these articles available on the ACDIS website:
- Put PEPPER to proper use
- Tip: Use PEPPER reports to search for CDI targets
- Q&A: RAC, medical necessity, and the role of CDI
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