This webinar will provide participants involved in coding, documentation improvement and revenue cycle functions with a brief overview of the changes made to the Inpatient Prospective Payment System (IPPS) for FY2022, that pertain to Medicare payment rates, the MS-DRG relative weights, New Technology Add-on payments, and the Medicare Code Editor. The main focus of this webinar will be on the changes to the MS-DRGs, the MCC/CC and O.R. Lists, and the hospital quality programs that impact hospital Medicare payments.
This webinar will provide participants involved in coding, documentation improvement and revenue cycle functions with a brief overview of the changes made to the Inpatient Prospective Payment System (IPPS) for FY2022, that pertain to Medicare payment rates, the MS-DRG relative weights, New Technology Add-on payments, and the Medicare Code Editor. The main focus of this webinar will be on the changes to the MS-DRGs, the MCC/CC and O.R. Lists, and the hospital quality programs that impact hospital Medicare payments.
“This program has been approved for 1.00 continuing education unit(s) for use in fulfilling the continuing education requirements of the American Health Information Management Association (AHIMA). Granting prior approval from AHIMA does not constitute endorsement of the program content or its program sponsor.”
This activity is approved for 1.00 contact hours.
Outline:
Webinar Objectives
Remind audience why CMS Makes Changes to IPPS Every Year
Goal
Objectives
Describe Changes to Short Term Acute Hospital Payment Rates
Base Payment Rate Increase
Disproportionate Share Payments
Graduate Medical Education Adjustment
Capital payment
Outlier threshold
Compare FY2022 MS-DRG Relative Weights (RWs) to FY2021 Relative Weights and Discuss Impact on Case Mix Index (CMI)
Top 20 DRGs with biggest increase in RWs
Top 20 DRGs with biggest decrease in RWs
CMS’ repealing proposal to move to market-based weights by FY2024
Explain Revisions to the MS-DRG Classification
New Methodology for (re)forming DRG Groupings (MCC, CC, MCC/CC, CC/non-CC, Non-CC)
Revisions to MS-DRG 18 CAR T-Cell Therapy
Procedure Code Reassignments
MDC 1 – MS-DRGs 40-42
MDC 3 – MS-DRGs 140-146
MDC 4 – MS-DRGs 163-168
MDC 5 – MS-DRG 215-221;
MDC 5- adding I21.A1 to AMI Grouper logic for MS-DRGs 222-223; Reassigning B33.24 from MDC 18 to MDC 5. Change to surgical hierarchy; Redefining and renaming MS-DRG s 233-234
MDC 8 – MS=DRGs.461-468 Adding knee replacement code combinations that were inadvertently left out of the logic
MDC 10– MS-DRGs.628-630 Adding knee replacement code combinations that were inadvertently left out of the logic
MDC 11 – Code 5A1D90Z getting lots of attention from CMS
MDC 16- MS=DRGs 814-816 Revising DRG structure, logic and codes
Adding procedures to MDC procedure lists to reduce number cases going to Unrelated O.R. Procedure DRGs – will itemize
Procedure codes moving from Extensive to non-extensive O.R. List and vice versa
Procedure codes moving from non-O.R to O.R. List
Changes to surgical hierarchies
CC and MCC List Revisions
Identify Changes to New Technology Methodology, Items on List and Their Codes and payments
Items removed from list
Items added to list
Present Changes to the Edits in the Medicare code editor (MCE)
Review revisions and updates to the following CMS quality programs and measures and their impact on hospital payment rates:
Hospital-Acquired Conditions (HAC) list and the HAC reduction program
Hospital Readmission Reduction Program (HRRP)
Hospital Inpatient Quality Reporting (IQR) program
Value based purchasing (VBP) program
Medicare and Medicaid Promoting Interoperability Programs
Lynn-Marie Wozniak, MS, RHIT, CDIP, FAHIMA has over 40 years of experience in health information management consulting, health services research, strategic planning, and health policy review and development. She is currently the CDI Analyst for the Rochester Regional Health System in Rochester, NY where she is responsible for tracking and reporting CDI productivity and impact metrics as well as analyzing impact of regulations and legislations on CDI processes and goals.
Prior to her current position, she spent 12 years as the Revenue Cycle Content Manager for Elsevier where she was responsible for the development and maintenance of e-learning curricula in CDI, patient financial services, hospital reimbursement, and quality measurement. Ms. Wozniak is a former member of the New York State Department of Health Data Protection Review Board and a past president of the New York Health Information Management Association. She has also served on AHIMA's Commission on Certification for Health Informatics and Information Management; Council on Accreditation; Research Review Panel; and the Program, Scholarship, and Nominating committees. She is an AHIMA Fellow and a recipient of AMRA's (now AHIMA's) Professional Achievement Award, as well as the NYHIMA Distinguished Member Award. Disclosure: Lynn-Marie Wozniak, MS, RHIT, CDIP, FAHIMA has declared that no conflict of interest, Relevant Financial Relationship or Relevant Non-Financial Relationship exists.
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