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Updates for MS-drg for coding and reimbursement - Admission/Application Essay Example

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Updates for MS-drg for coding and reimbursement

On October 1, 2008, the Centers for Medicare and Medical Services adopted the MS-DRGs system with the purpose of improving patient care and reduce unnecessary health care cost. It has strict regulations such that reimbursement of cost is specific only to the documented illness upon admission. Medicare will not pay for any additional costs incurred by hospitals due to other hospital-inquired infections of errors. Moreover, there are instances wherein Medicare will not allow payments for complication related costs such as “foreign objects retained after surgery, air embolism, blood incompatibility, stage III & IV pressure ulcers, falls and trauma, catheter-associated urinary tract infection (UTI), vascular catheter-associated infection or Mediastinitis after coronary artery bypass graft (CABG)” (US Payer News, 08 July 2008). The new system requires the hospital to overhaul the payment system of DRGs and be ready for the possibility of reductions in reimbursements. Hospitals will be required to do a lot of reporting to Medicare such as reports for hospital-acquired conditions. It is expected that hospitals will hand in quality reporting in an expanded set up. Hospitals are supposed to report also pricing changes. According to Ingenix, the implication of the new Medicare ruling is that by adjusting according to severity, cases without complications will be paid less and cases with high complications will be paid more.

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Summary

On October 1, 2008, the Centers for Medicare and Medical Services adopted the MS-DRGs system with the purpose of improving patient care and reduce unnecessary health care cost. It has strict regulations such that reimbursement of cost is specific only to the documented illness upon admission…
Updates for MS-drg for coding and reimbursement
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