July 9, 2018

Study: CMS policy on CLABSI, CAUTI has minimal effect on reimbursement

By: Judy Mathias
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Editor’s Note

This study found that the Centers for Medicare & Medicaid Services (CMS) hospital-acquired conditions policy on central line-associated bloodstream infections (CLABSI) and catheter-associated urinary tract infections (CAUTI) had minimal financial effects on hospitals because billing codes for CLABSI and CAUTI were rarely used and there was a significant increase in CLABSI and CAUTI codes marked as present on admission (POA) in the postpolicy period.

In this analysis of more than 65.2 million Medicare patients from January 1, 2007 to December 31, 2011, researchers found that CLABSI affected 0.23% of hospitalizations and CAUTI affected 0.06%. They also found a significant increase in CLABSI (82%) and CAUTI (91%) codes marked as POA.

For the small number coded as not POA, financial effects were detected on only 0.4% with a CLABSI code and 5.7% with a CAUTI code.

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