No industry or profession is immune to the budget crunch. Unfortunately, many coding departments fall into a routine and neglect to assess their costs and look for innovative ways to save money.
CMS finalized a documentation and coding adjustment (DCA) of -2% for fiscal year (FY) 2012, according to the inpatient prospective payment system (IPPS) final rule. CMS originally proposed a year-over-year reduction of 0.5% in payments to acute care hospitals, including a DCA of -3.15%. However, CMS finalized a cut of 2%, a decrease from 2.9% in FY 2011, which translates to $1.13 billion more in hospital payments in FY 2012 than hospitals received the previous year.
Organizations have had their chance to weigh in on the proposed accounting of disclosures rule, and some larger ones don't exactly see it working as written. Here is what some organizations had to say.
CMS has proposed to rescind the requirement for signatures on all lab requisitions, according to the "Medicare Program; Clinical Laboratory Fee Schedule: Signature on Requisition" proposed rule published in the Federal Register June 30. The 2011 Medicare Physician Fee Schedule, published last November, requires a physician's or nonphysician practitioner's (NPP) signature on lab requisitions for tests paid under the clinical lab fee schedule, regardless of whether there is a signed order. This is the opposite of prior CMS rulings that indicated signatures were not required on requisitions, although written and signed orders were required.
The Program for Evaluating Payment Patterns Electronic Report (PEPPER), distributed either quarterly or annually depending on the type of facility, contains large amounts of data on how a facility compares to others in the same state, the same jurisdiction (i.e., the same Medicare Administrative Contractor), and nationwide in terms of coding and medical necessity target areas. (Find out more at www.pepperresources.org.)PEPPER identifies when facilities are outliers in their reporting of multiple risk areas. For coding, those areas are:
