Author: Prophet, Sue

Source: Journal of AHIMA

Publication Date: October 1998

All of the inpatient DRG and other inpatient Prospective Payment System (PPS) changes described below became effective with discharges occurring on or after October 1, 1998. Complete details of these changes can be found in the Federal Register.1
Transfers to Postacute Settings

....

Author: Wilson, Valerie; Hammer, Juanita; Washburn, Daniel

Source: Journal of AHIMA

Publication Date: February 1999

St. Mary's Mercy Hospital is a 277-bed acute care facility in northwestern Oklahoma. Serving as a regional referral center, the facility provides acute medical and surgical services, critical care, neurosurgical services, inpatient rehabilitation, a skilled nursing unit, ambulatory sur....

Author: Bryant, Gloryanne H.

Source: Journal of AHIMA

Publication Date: September 1999

Earlier this year, the Office of the Inspector General (OIG) informed the Health Care Financing Administration (HCFA) that "the DRG system is vulnerable to abuse by providers who wish to increase reimbursement inappropriately through upcoding, particularly so within certain DRGs.&....

Author: Noller, Janice R.

Source: Journal of AHIMA

Publication Date: January 2000

To investigate high complication rates, coders at this facility found themselves working to improve communication, physician understanding of coder issues, and data quality. (FORE Best Practice, AHIMA Foundation)

Author: Limjoco, Cesar M.; Youmans, Karen

Source: Journal of AHIMA - Coding Notes

Publication Date: March 2000

In March 1999, the Office of Inspector General (OIG) released an executive summary on "Medicare Payments for Septicemia." The Health Care Financing Administration (HCFA) contracted with two clinical data abstraction centers to validate a national random sample of claims from all Medicare inpat....

Author: Prophet, Sue

Source: Journal of AHIMA - Coding Notes

Publication Date: November 2000

Effective October 1, 2000, 100 new ICD-9-CM diagnosis codes and nine new ICD-9-CM procedure codes have been implemented. Because there were no ICD-9-CM revisions last year, these new codes are the result of two years’ worth of revisions. Coding professionals should familiarize themselves with....

Author: Hapner, Peggy

Source: Journal of AHIMA - Coding Notes

Publication Date: May 2001

As HIM professionals already know, data quality-one of the basic tenets of compliance-depends on comprehensive documentation and accurate code assignments. Because coding plays a major role in payment, reporting data accurately, managing data flow and data collection, and training st....

Author: Osborn, Carol E.

Source: Journal of AHIMA

Publication Date: July 2001

Author: Stratton, Scott D.

Source: Journal of AHIMA

Publication Date: September 2001

The third installment of the Journal of AHIMA’s special series on managed care focuses on informatics-methods that add value to data, turning it into useful information. How do informatics and managed care fit together, and what is HIM’s role in this picture?

The HIM professional’s knowl....

Author: Bryant, Gloryanne H.

Source: AHIMA Convention

Publication Date: October 10, 2001

Introduction

Physicians and interdisciplinary staff document in the medical record but not in a manner that adequately reflects the acuity and severity of the patient's clinical presentation-often not accurately enough to reflect the detail of care being delivered, which resu....

Author: Uppena, Mary

Source: Journal of AHIMA - Coding Notes

Publication Date: November 2001

The 2002 diagnosis related group (DRG) updates went into effect October 1, 2001. With the implementation of these changes to the hospital inpatient DRGs portion of the prospective payment system (PPS), there will be 499 DRGs in 25 Major Diagnostic Categories (MDCs).


Changes t....

Author: Averill, Richard F.

Source: Journal of AHIMA

Publication Date: January 2002

Are you fluent in DRG? This article takes a look at the evolution of the three distinct DRG systems and spotlights the most recent iteration, All-Patient Refined DRGs. It also sheds light on how this system, when codes are properly applied, can help an organization study morbidity and mortalit....

Author: Rode, Dan

Source: AHIMA testimony and comments

Publication Date: July 01, 2002

AHIMA
233 N. Michigan Avenue, Suite 2150
Chicago, Illinois 60601-5519
Phone: 312.233.1115
Fax: 312.233.1090
E-mail: sue.prophet@ahima.org
July 1, 2002


Thomas A. Scully
Administrator
Centers for Medicare & Medicaid Services
Department of H....

Author: Dougherty, Michelle

Source: Journal of AHIMA

Publication Date: July 2002

In the past 10 years, the number of new long-term care hospitals (LTCHs) in the United States has tripled. Because of this growth, LTCHs are the newest post-acute settings to face a change in the reimbursement system.


While there are only about 270 LTCHs in the United States, t....

Author: AHIMA Policy and Government Relations Team

Source: AHIMA regulation analysis

Publication Date: August 02, 2002

The final rule regarding FY 2003 revisions to the Medicare hospital inpatient prospective payment system (PPS) was published in the August 1, 2002 issue of the Federal Register.



This rule becomes effective on October 1, 2002.This analysis will cover changes to DRG classificat....

Author: Wozniak, Lynn-Marie

Source: AHIMA Convention

Publication Date: September 23, 2002

Author: Zeisset, Ann M.

Source: Journal of AHIMA - Coding Notes

Publication Date: November 2002

The ICD-9-CM coding changes and DRG changes for fiscal year 2003 include 106 new diagnosis codes, 41 new V codes, 16 new E codes, 25 new procedure codes, and 19 invalid diagnosis codes. Released in the August 1, 2002, Federal Register, these changes went into effect October 1, 2002, with disch....

Author:

Source: AHIMA web extra

Publication Date: November 02, 2002

New 2003 ICD-9-CM codes and DRG assignments

Author: Prophet-Bowman, Sue

Source: Journal of AHIMA

Publication Date: January 2003

This article includes highlights of the OIG’s 2003 Work Plan. The plan can be found in its entirety on the OIG Web site at http://oig.hhs.gov/ publications/workplan.html.
Many of the projects described in the 2003 Work Plan of the Office of Inspector General (OIG) of the Department of Hea....

Author: Hull, Susan

Source: Journal of AHIMA - Coding Notes

Publication Date: June 2003

A prospective payment system has been in effect for Medicare reimbursement for various healthcare providers for almost 20 years. Most recently, long-term acute care hospital (LTCH) facilities have been added to the prospectively reimbursed providers. This is a significant change from the cost-....

Author: Mullin, Robert L.

Source: Journal of AHIMA - Coding Notes

Publication Date: July 2003

For accurate profiling and utilization assessment, a single patient classification system compatible with a wide variety of coding systems and clinical practices is needed. It also provides a reliable basis for healthcare funding and budgeting. However, many of the patient classification syste....

Author: Rode, Dan

Source: AHIMA testimony and comments

Publication Date: July 07, 2003

July 7, 2003

Thomas A. Scully
Administrator
Centers for Medicare & Medicaid Services
Department of Health and Human Services
Attention: CMS-1470-P
PO Box 8010
Baltimore, Maryland 21244-1850




Dear Mr. Scully:

The purpose....

Author: U.S. Centers for Medicare & Medicaid Services

Source: Government (U.S.)

Publication Date: September 24, 2003

LTC-DRG Description Relative Weight Geometric Average Length of Stay 5/6th of the Average Length of Stay 1 5 CRANIOTOMY AGE>17 W CC 2.0841 40.0 33.3 2 <....

Author: Zeisset, Ann M.

Source: Journal of AHIMA - Coding Notes

Publication Date: November 2003

New ICD-9-CM codes and DRG changes for fiscal year 2004 were released in the August 1, 2003, Federal Register. These changes went into effect October 1, 2003, with discharges occurring on or after that date. There were 104 new diagnosis codes and 10 new procedure codes. Due to code expansions,....

Author:

Source: Journal of AHIMA

Publication Date: November 2003

ICD-9-CM codes with their DRG assignments