Bush signs funding bill giving more to hospitals
More than $800 million in increased spending for hospitals is included in the omnibus spending bill signed in late February by President Bush.
The legislation includes a $300 million increase from April 1 through Sept. 20 in Medicare payments for rural and "other urban" hospitals through equalization of the standardized rate. It also provides $518 million in bioterrorism preparedness funding for hospitals, $15 million in new funding for the Nurse Reinvestment Act, and $28 million in education incentives for medical schools to incorporate bioterrorism-related information in their curriculums.
CPT-4 coding inconsistent; templates could help
Agreement in coding of emergency charts between coding agencies used by one hospital system was only poor to fair, and the distribution of assigned CPT-4 codes was significantly different among the agencies, according to a study from William Beaumont Hospital System in Royal Oak, MI, published in the Annals of Emergency Medicine (Bentley PN, Wilson AG, Derwin ME, et al. Reliability of assigning correct current procedural terminology-4 E/M codes. Ann Emerg Med 2002; 40:269-274).
The researchers did three prospective trials, with two interagency audits and one intra-agency audit. In addition to poor agreement in coding, they found that the distribution of CPT-4 codes was significantly different in each group.
"We find this latter observation startling and disturbing, and if generalizable, this will have important economic and legal ramifications," they wrote, pointing to the possibility of prosecution for billing fraud. They suggested the following solutions:
- using templates to reduce variation of documentation;
- requiring more rigorous formatting of dictations for more consistent documentation;
- performing a more thorough review of documentation guidelines provided by the Centers for Medicaid & Medicare Services (CMS) for use in assigning CPT codes.
(Editor’s note: The guidelines can be downloaded at no charge at the CMS web site: cms.hhs.gov. Click on "Medicare" and "Documentation Guidelines for Evaluation and Management Services.")
Feds offer database for record disclosures
The Centers for Medicare & Medicaid Services (CMS) has created a Privacy Accountability Database to aid in tracking, reporting, and accounting for the disclosures made from all CMS systems of records permitted by the Privacy Act of 1974 and the Health Insurance Portability and Accountability Act.
Information retrieved from the system will be used to support regulatory, reimbursement, and policy functions performed within the agency or by a contractor or consultant, support constituent requests made to a congressional representative, and support litigation involving the agency.
The system can be accessed at www.access.gpo.gov/su_docs/fedreg/a021007c.html.
Bush signs funding bill giving more to hospitals; CPT-4 coding inconsistent; templates could help; Feds offer database for record disclosuresYou have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
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