CMS clarifies ICD-10 implementation issues
Editor's Note The Centers for Medicare and Medicaid Services (CMS) reports that it will reprocess ICD-10 claims with National Coverage Determination and Local Coverage Determination errors automatically and at no cost to providers. CMS is also waiting to reprocess some claims with errors resulting from Local Coverage Determinations until Medicare…
OIG announces new initiatives for ASCs
Editor's Note The US Department of Health & Human Services Office of the Inspector General (OIG) released its 2016 Work Plan announcing new initiatives for ambulatory surgery centers (ASCs), the ASCA News Digest reports. The initiatives include: Review the appropriateness of Medicare’s methodology for setting ASC payment rates. Revitalize outdated…
Survey: ICD-10 has reduced hospital productivity
Editor's Note In a survey by Himagine Solutions, large hospitals reported a 30% to 45% reduction in productivity for inpatients and a 20% to 40% reduction for outpatients since implementation of the ICD-10 codes, Healthcare Informatics reports. Though loss in productivity can mean a disruption to the revenue cycle, one…
Specific care bundles successfully cut surgical site infection rates
Three new studies on reducing surgical site infections (SSIs) were reported at the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) conference in July. Researchers at three different institutions identified several process changes that, once implemented, brought down SSI rates. Each study used different methodology, but all…
Build a strong anesthesia quality program to boost patient safety and the bottom line
Quality indicators for anesthesia For the past several years, physicians have participated in the Physician Quality Reporting System (PQRS) established by Medicare as a way to assess the quality of patient care and tie that to reimbursement. Beginning in 2015, a negative payment adjustment hit individuals and group practices whose…
CMS finalizes rule for hip and knee bundled payments
Editor's Note The Centers for Medicare and Medicaid Services (CMS) has finalized the rule that will require hospitals in 67 geographic areas to participate in a test of bundled payments for hip and knee replacements, Modern Healthcare reports. Medicare's average bundled payment ranges from $16,500 to $33,000 for surgery, hospitalization,…
Study: Readmission common after emergency general surgery
Editor's Note Readmission after emergency general surgery procedures is common and varies widely according to patient factors and diagnosis, this study finds. Of more than 177,000 patients analyzed, nearly 6% were readmitted within 30 days. The most common reasons were surgical site infections (16.9%), gastrointestinal complications (11.3%), and pulmonary complications…
NIS database used for hospital reimbursement contains major flaws
Editor's Note The Nationwide Inpatient Sample (NIS) database underreports data on patients’ weight, body mass, alcohol use, and tobacco use, finds a study from the Johns Hopkins University School of Medicine, Baltimore. Medicare uses NIS data to set reimbursement rates based on a hospital’s risk for readmissions and surgical complications. The…
Medical societies plead with Congress to fix ‘meaningful use’
Editor's Note A coalition of 111 medical societies on November 4 sent letters asking Senate and House leaders to take legislative action to pause Stage 3 of the electronic health records meaningful use program and revise Stage 2 so that it enables provider success, HealthData Management reports. Stage 3 requirements…
Medicare releases 2016 final ASC payment rule
Editor's Note On October 30, the Centers for Medicare & Medicaid Services (CMS) released the final 2016 payment rule for ambulatory surgery centers (ASCs). ASC payment rates will increase by 0.3%, which is based on a projected inflation rate of 0.8% minus a 0.5% productivity adjustment required by the Affordable…
Free Daily News
- OR Business Management Conference: Lowest rates expire soon
- Study: Women face higher mortality risk than men for postop atrial fibrillation after cardiac surgery
- Time to sign up for the ASC administrators CASC training course
- Brain implant leverages AI, neural sensors to restore speech for ALS patient
- Study: Nearly 10% of patients on prescription opioids develop dependency or disorder
- CMS expands social determinants of health screening to outpatient settings
- Origami-inspired brain implants hold promise for Epilepsy surgery
- Surveyed nurses more satisfied with electronic health records, but concerns remain
- Countdown to OR Manager Conference: Implementation of a training program in an ASC
- FDA approves single-dose propofol amid drug shortage