Go for the Gold. Hospital Outpatient Measures (HOP) Data Abstraction Scenarios. June 9 11, 2008 Starr Pass Resort Tucson, Arizona
|
|
- Randall Hopkins
- 5 years ago
- Views:
Transcription
1 Go for the Gold June 9 11, 2008 Starr Pass Resort Tucson, Arizona Hospital Outpatient Measures (HOP) Data Abstraction Scenarios Does the Hospital Outpatient Program have you hopping? The HOP initiative, beginning with April 2008 discharges, was developed by CMS to reflect quality of care in hospital based outpatient settings. This measure is required for hospitals wanting to receive their full Medicare OPPS Annual Payment Update. In this session we will cover the three Focus Studies that comprise HOP: HOP Acute MI, HOP Chest Pain, and HOP SCIP. Data abstraction guidelines will be covered using case studies entered into the MIDAS+ Care Management System for each type of outpatient qualifying for this measure set. Presented by: Dawn Harrison Clinical Resource Analyst, ACS MIDAS+
2 Post-Symposium Availability Shortly after the conclusion of this year s Symposium, some General Session and all Breakout Session presentations will be available for downloading by licensed MIDAS+ clients from our Clients Only Web site. The presentations will be available online in PDF format. Copies of presentations in native PowerPoint format are not generally available. Copyright 2008 MidasPlus, Inc. All Rights Reserved. Contact us at: ACS Healthcare Solutions MIDAS North Pantano Road, Suite 200 Tucson, Arizona (520) (800) Visit our Web site at: MIDAS+, the MIDAS+ logo, DataVision, ReporTrack, Seeker, and SmarTrack are trademarks of MidasPlus, Inc. The ACS logo is a registered trademark of ACS, Inc. Third party trademarks, trade names, product names, and logos may be the trademarks or registered trademarks of their respective owners.
3 Hospital Outpatient Measures (HOP) Data Abstraction Scenarios HOP Data Abstraction Case Study Scenarios Dawn Harrison RN, MSN Clinical Resource Specialist/Analyst ACS MIDAS+ Tucson, AZ Objectives Describe the Hospital Outpatient Department (HOP) National Quality Measures and key data elements Demonstrate abstraction of a HOP case study into the MIDAS+ Focus Encounter Entry 17th Annual MIDAS+ User Symposium Tucson, Arizona June
4 Hospital Outpatient Measures (HOP) Data Abstraction Scenarios HOP AMI/Chest Pain - 2 distinct populations: Acute Myocardial Infarction: OP-1 through OP-5 E/M Code Discharge Status Outpatient Encounter Date earliest documented date patient arrived Birthdate ICD-9-CM Principal Diagnosis Code Chest Pain: OP-4 through OP-5 E/M Code Discharge Status Outpatient Encounter Date earliest documented date patient arrived Birthdate ICD-9-CM Principal Diagnosis Code ICD-9-CM Other Diagnosis Codes AMI HOP Population E/M code: the code used to report evaluation and management services provided in the hospital outpatient department clinic or ED. Must be a valid E/M code from Appendix A, OP Table 1.0 Exclude from HOP Measure Population Not a valid E/M code found on Table 1.0 = Excluded from HOP Measure Population Only qualifying D/C status codes: 02 - D/C or transferred to a short term general hospital for inpatient care 43 D/C or transferred to a Federal health care facility 66 D/C or transferred to a Critical Access Hospital 2 17th Annual MIDAS+ User Symposium Tucson, Arizona June 2008
5 Hospital Outpatient Measures (HOP) Data Abstraction Scenarios AMI HOP Population Outpatient Encounter Date: The earliest date the patient arrived in the hospital outpatient setting ICD-9 Principal Codes in Appendix A OP Table 1.1: Acute MI Diagnosis Codes Excluded: Patients less than 18 years Excluded from measure Population if Principal DX code is NOT on OP Table 1.1 Chest Pain HOP Population E/M code: the code used to report evaluation and management services provided in the hospital outpatient department clinic or ED. Must be a valid E/M code from Appendix A, OP Table 1.0 Not a valid E/M code found on Table 1.0 = Excluded from HOP Measure Population Exclude from HOP Measure Population Only qualifying D/C status codes: 02 - D/C or transferred to a short term general hospital for inpatient care 43 D/C or transferred to a Federal health care facility 66 D/C or transferred to a Critical Access Hospital 17th Annual MIDAS+ User Symposium Tucson, Arizona June
6 Hospital Outpatient Measures (HOP) Data Abstraction Scenarios Chest Pain HOP Population Outpatient Encounter Date: The earliest date the patient arrived in the hospital outpatient setting ICD-9 Principal Codes in Appendix A OP Table 1.1a: Chest Pain Diagnosis Codes Excluded: Patients less than 18 years Excluded from Outpatient Chest Pain measure Population if Other DX code is NOT on OP Table 1.1a Excluded from Outpatient Chest Pain measure Population if Principal DX code is NOT on OP Table 1.1 *Principal or Other (secondary) ICD-9 Diagnosis Code of Chest Pain qualifies for Chest Pain population HOP Surgical Measures Surgical: OP-6 through OP-7 CPT Code Outpatient Encounter Date earliest documented date patient arrived Birthdate Patients with Lap Cholecystectomy procedure codes LESS THAN 70 years of age are EXCLUDED from the study) 4 17th Annual MIDAS+ User Symposium Tucson, Arizona June 2008
7 Hospital Outpatient Measures (HOP) Data Abstraction Scenarios Surgical HOP Population Does the Patient have a qualifying CPT-4 code on Table 6.0? Outpatient Encounter Date: The earliest date the patient arrived in the hospital outpatient setting If no qualifying CPT-4 code or less than 18 years of age, patient is not in the HOP OP-6 or OP-7 population Does the Patient have a qualifying CPT-4 code on Table 6.4b? Is the patient 70 years or older?, then they are IN the OP-6 and OP-7 population. Key Points AMI and Chest Pain Measures E/M Code and Discharge Status are key for the case to qualify Largely focused on pre-transfer care of AMI patients Surgery Measures Timely delivery of antibiotic w/in 60 min before incision Use of a guideline recommended antibiotic Looks specifically at Antibiotic Name and Route 17th Annual MIDAS+ User Symposium Tucson, Arizona June
8 MIDAS+ Comparative Performance Measurement System Core Hospital Outpatient Program Acute MI PATIENT NAME FOCUS WORKSHEET ACCOUNT NO. MEDICARE ID # (HIC #) FACILITY NAME OUTPATIENT ENCOUNTER DATE DATE OF BIRTH DISCHARGE DATE UTD Core HOP Acute MI: Focus Questions (Page 1 of 2) 1. E/M Code: None of the above 2. Discharge Status: 01 Home care or self care (routine discharge) 07 Left against medical advice 09 Medicare outpatient admitted as 61 Medicare approved swing bed 62 Inpatient rehab facility (IRF) 02 Short term general hospital for inpatient to this hospital inpatient care 63 Medicare certified long term care 20 Expired in acute care hospital 03 Medicare certified skilled nursing facility (SNF) 41 Expired in medical facility 64 Nursing facility Medicaid only [Medicare, CHAMPUS only] 65 Psychiatric hospital 04 Intermediate care facility 43 Federal health care facility 66 Discharge to critical access hospital 05 Designated center or children s hospital 50 Hospice home care program 70 Another institution not in this code list 06 Home with home health 51 Hospice certified medical facility providing hospice 3. Discharge Status Confirmed: Yes No 4. Payment Source: 5. Race: 1 Medicare (Title 18) 1 White 5 Native Hawaiian/Pacific Islander 2 Medicaid (Title 19) 2 Black or African 7 UTD 3 Other American 4 No insurance/not documented/utd 5 Medicare Other 3 American Indian/Alaska Native 4 Asian 6. Hispanic or Latino Ethnicity: Yes No/UTD 7. ED Arrival Time: UTD 8. Discharge Time: UTD 9. Probable Cardiac Chest Pain: Yes No 11. Contraindication to Aspirin: 1 Allergy/Sensitivity to aspirin 2 Coumadin/warfarin prescribed pre-arrival 10. Aspirin Received: Yes No 3 Other documented reasons 4 No documented contraindication/utd 12. ECG: Yes No 13. ECG Date: UTD 14. ECG Time: UTD Healthcare Solutions 2500 North Pantao Road Tucson, AZ midas.core@acs-inc.com April 1, 2008 Discharges
9 PATIENT NAME CORE HOP ACUTE MI PAGE 2 OF Initial ECG Interpretation: 16. Fibrinolytic Administration: Yes No Yes No 17. Fibrinolytic Administration Date: UTD 18. Fibrinolytic Administration Time: UTD 19. Reason for Not Administering Lytics: 1 Documented contraindication/reason 2 Cardiogenic Shock 3 No contraindication/utd 20. Reason for Delay in Lytic Therapy: Yes No 21. Transfer for Acute Coronary Intervention: 1 Pt transferred from this ED to another facility for acute coronary intervention 2 Pt was admitted to observation status prior to transfer 3 Pt transferred from this ED to another facility for other reasons/utd Healthcare Solutions 2500 North Pantao Road Tucson, AZ midas.core@acs-inc.com April 1, 2008 Discharges
10 MIDAS+ Comparative Performance Measurement System Core Hospital Outpatient Program Surgery PATIENT NAME FOCUS WORKSHEET ACCOUNT NO. MEDICARE ID # (HIC #) FACILITY NAME OUTPATIENT ENCOUNTER DATE DATE OF BIRTH DISCHARGE DATE Core HOP Surgery: Focus Questions (Page 1 of 2) 1. Earliest Qualifying CPT Procedure: 2. Earliest Qualifying CPT Procedure Date: 3. Payment Source: 4. Race: 1 Medicare (Title 18) 2 Medicaid (Title 19) 3 Other 4 No insurance/not documented/utd 5 Medicare Other 1 White 2 Black or African American 3 American Indian/Alaska Native 4 Asian 5 Native Hawaiian/Pacific Islander 7 UTD 5. Hispanic Ethnicity: Yes No/UTD 6. Clinical Trial: Yes No 7. Infection Prior to Anesthesia: Yes No 8. Antibiotic: Yes No 9. Antibiotic Timing: Yes No 10. Antibiotic Allergy: Yes No 11. Vancomycin: 1 Beta-lactam (penicillin or cephalosporin) allergy 2 MD/APN/PA/RPH documentation of known infection or colonization with MRSA 5 MD/APN/PA/RPH documentation of increased MRSA rate, facilitywide or operation-specific 6 MD/APN/PA/RPH documentation of chronic wound care or dialysis 3 MD/APN/PA/RPH documentation of high risk due to acute inpatient hospitalization within last year 4 MD/APN/PA/RPH documentation of pt being high-risk due to nursing home or extended care facility within last year prior to admission 8 Other MD/APN/PA/RPH documented reason 9 No documented reason / Unable to determine Antibiotics Administered: Name of Antibiotic Antibiotic Administration Route 1 1 PO/NG/PEG tube 2 1 PO/NG/PEG tube 3 1 PO/NG/PEG tube 4 1 PO/NG/PEG tube Healthcare Solutions 2500 North Pantao Road Tucson, AZ midas.core@acs-inc.com April 1, 2008 Discharges
11 Patient Name: Core HOP Surgery, Page 2 of PO/NG/PEG tube 6 1 PO/NG/PEG tube 7 1 PO/NG/PEG tube 8 1 PO/NG/PEG tube 9 1 PO/NG/PEG tube 10 1 PO/NG/PEG tube 11 1 PO/NG/PEG tube 12 1 PO/NG/PEG tube 13 1 PO/NG/PEG tube 14 1 PO/NG/PEG tube 15 1 PO/NG/PEG tube 16 1 PO/NG/PEG tube 17 1 PO/NG/PEG tube 18 1 PO/NG/PEG tube 19 1 PO/NG/PEG tube 20 1 PO/NG/PEG tube Healthcare Solutions 2500 North Pantao Road Tucson, AZ midas.core@acs-inc.com April 1, 2008 Discharges
12 MIDAS+ Comparative Performance Measurement System Core Hospital Outpatient Program Chest Pain PATIENT NAME FOCUS WORKSHEET ACCOUNT NO. MEDICARE ID # (HIC #) FACILITY NAME OUTPATIENT ENCOUNTER DATE DATE OF BIRTH DISCHARGE DATE Core HOP Chest Pain: Focus Questions 1. E/M Code: Discharge Status: 01 Home care or self care (routine discharge) 02 Short term general hospital for inpatient care 03 Medicare certified skilled nursing facility (SNF) 04 Intermediate care facility 05 Designated center or children s hospital 06 Home with home health Left against medical advice 09 Medicare outpatient admitted as inpatient to this hospital 20 Expired in acute care 41 Expired in medical facility [Medicare, CHAMPUS only] 43 Federal health care facility 50 Hospice home care program 51 Hospice certified medical facility providing hospice None of the above 61 Medicare approved swing bed 62 Inpatient rehab facility (IRF) 63 Medicare certified long term care hospital 64 Nursing facility Medicaid only 65 Psychiatric hospital 66 Discharge to critical access hospital 70 Another institution not in this code list 3. Discharge status confirmed: Yes No 4. Payment Source: 5. Race: 1 Medicare (Title 18) 2 Medicaid (Title 19) 1 White 2 Black or 5 Native Hawaiian/Pacific Islander 3 Other 4 No insurance/not documented/utd African 7 UTD American 3 American 5 Medicare Other Indian/Alaska Native 4 Asian 6. Hispanic or Latino Ethnicity: Yes No/UTD 7. ED Arrival Time: UTD 8. Probable Cardiac Chest Pain: Yes No 9. Aspirin Received: Yes No 11. Contraindication to Aspirin: 1 Allergy/sensitivity to Aspirin 3 Other documented reasons 2 Coumadin/warfarin prescribed pre-arrival 4 No documented contraindication/utd 12. ECG: Yes No 13. ECG Date: UTD 14. ECG Time: UTD Healthcare Solutions 2500 North Pantao Road Tucson, AZ midas.core@acs-inc.com April 1, 2008 Discharges
13 NOTES 17th Annual MIDAS+ User Symposium Tucson, Arizona June 2008
Administrative Billing Data
Administrative Billing Data Patient Identification and Demographic Information: From UB-04 Data or Medical Record Face Sheet. Note: When you go to enter data on this case, the information below will already
More informationGo for the Gold. Incorporating Regulatory Issues into the Quality Management Process. June 9 11, 2008 Starr Pass Resort Tucson, Arizona
Go for the Gold June 9 11, 2008 Starr Pass Resort Tucson, Arizona Incorporating Regulatory Issues into the Quality Management Process Recent regulatory changes have impacted the traditional hospital Quality
More informationAbstraction Tricks and Tips for the Hospital Outpatient Quality Reporting (OQR) Program
Abstraction Tricks and Tips for the Hospital Outpatient Quality Reporting (OQR) Program Audio for this event is available via internet streaming. No telephone line is required. Computer speakers or headphones
More informationNews SEPTEMBER. Hospital Outpatient Quality Reporting Program. Support Contractor
Volume 1, Issue 4 Hospital Outpatient Quality Reporting Program Support Contractor News SEPTEMBER 2011 In This Issue... Emergency Department Arrival and Departure Times Page 2 Hospital OQR Benchmarks Page
More informationAbstraction Tricks and Tips for the Hospital Outpatient Quality Reporting (OQR) Program
Abstraction Tricks and Tips for the Hospital Outpatient Quality Reporting (OQR) Program Audio for this event is available via internet streaming. No telephone line is required. Computer speakers or headphones
More informationTaking the Mis Out of Mismatch: Top 10 Mismatched Data Elements from Q through Q April 17, 2013
Taking the Mis Out of Mismatch: Top 10 Mismatched Data Elements from Q2 2011 through Q1 2012 April 17, 2013 Announcements 2 Upcoming Report Dates Hospitals are responsible for ensuring that their Hospital
More informationNational Hospital Inpatient Quality Reporting Measures Specifications Manual
National Hospital Inpatient Quality Reporting Measures Specifications Manual Release Notes Version: 4.4a Release Notes Completed: October 21, 2014 Guidelines for Using Release Notes Release Notes 4.4a
More informationExploring the Possibilities with MIDAS+ SmartConnect
June 1 3, 2009 Westin La Paloma Resort Tucson, Arizona Exploring the Possibilities with MIDAS+ SmartConnect Leverage your existing MIDAS+ Care Management tools and consider automating your transition planning
More informationHospital Compare Quality Measures: 2008 National and Florida Results for Critical Access Hospitals
Hospital Compare Quality Measures: National and Results for Critical Access Hospitals Michelle Casey, MS, Michele Burlew, MS, Ira Moscovice, PhD University of Minnesota Rural Health Research Center Introduction
More informationFACT SHEET Summary of Acute Myocardial Infarction (AMI) and Heart Failure (HF) Changes for 1/1/12+ Discharges
FACT SHEET Summary of Acute Myocardial Infarction (AMI) and Heart Failure (HF) Changes for 1/1/12+ Discharges AMI-1, AMI-3, and AMI-5: Submission to the CMS clinical data warehouse is now optional. This
More informationMeaningful Use Stage 2 Clinical Quality Measures Are You Ready?
22nd Annual Midas+ User Symposium June 2 5, 2013 Tucson, Arizona Meaningful Use Stage 2 Clinical Quality Measures Are You Ready? Tuesday, June 4, 1:00 pm The transition from chart-abstracted legacy core
More informationThe Medicare Beneficiary Quality Improvement Project (MBQIP) Monthly Performance Improvement Call
The Medicare Beneficiary Quality Improvement Project (MBQIP) Monthly Performance Improvement Call April 16, 2015 Amber Theel, Executive Director Patient Safety Susan Rivera-Lee, WSHA Consultant MBQIP MBQIP
More informationEmergency Department Update 2009 Outpatient Payment System
Emergency Department Update 2009 Outpatient Payment System ED Facility Level Guidelines Critical Care Composite APCs and No Diagnosis Limitations OPPS Facility Conversion Factor Update Hospital Outpatient
More informationEmergency Department Update 2010 Outpatient Payment System
Emergency Department Update 2010 Outpatient Payment System ED Facility Level Guidelines: Still No National Guidelines Triage Only Services Critical Care Requires CMS Documentation E/M Physician of Payment
More informationOutpatient Quality Reporting Program
Outpatient Quality Reporting Program Hospital Outpatient Quality Reporting (OQR) Program 2018 Specifications Manual Update Questions & Answers Moderator: Pam Harris, BSN, RN Speaker: Melissa Thompson,
More informationPatient Care Practice Council Shared Governance Model
May 22 24, 2006 Starr Pass Resort Tucson, Arizona Patient Care Practice Council Shared Governance Model Learn about this Shared Governance Model designed to improve care at the bedside and about a comprehensive
More informationNEW JERSEY HOSPITAL PERFORMANCE REPORT 2014 DATA PUBLISHED 2016 TECHNICAL REPORT: METHODOLOGY RECOMMENDED CARE (PROCESS OF CARE) MEASURES
NEW JERSEY HOSPITAL PERFORMANCE REPORT 2014 DATA PUBLISHED 2016 TECHNICAL REPORT: METHODOLOGY RECOMMENDED CARE (PROCESS OF CARE) MEASURES New Jersey Department of Health Health Care Quality Assessment
More informationMinnesota Statewide Quality Reporting and Measurement System: APPENDICES TO MINNESOTA ADMINISTRATIVE RULES, CHAPTER 4654
Minnesota Statewide Quality Reporting and Measurement System: APPENDICES TO MINNESOTA ADMINISTRATIVE RULES, CHAPTER 4654 DECEMBER 2017 APPENDICES TO MINNESOTA ADMINISTRATIVE RULES, CHAPTER 4654 Minnesota
More informationNorth Carolina Ambulatory Surgery Visit Data - Data Dictionary FY2011 Alphabetic List of Variables and Attributes Standard Research File
North Carolina Ambulatory Surgery Visit Data - Data Dictionary FY2011 Alphabetic List of Variables and Attributes Standard Research File One of these three variables must be suppressed (Diag1, fac, ptzip)
More informationOP ED-THROUGHPUT GENERAL DATA ELEMENT LIST. All Records
Material inside brackets ( [ and ] ) is new to this Specifications Manual version. HOSPITAL OUTPATIENT QUALITY MEASURES ED-Throughput Set Measure ID # OP-18 OP-20 OP-22 Measure Short Name Median Time from
More informationNorth Carolina Emergency Department Visit Data - Data Dictionary FY2012 Alphabetic List of Variables and Attributes Standard Research File
North Carolina Emergency Department Visit Data - Data Dictionary FY2012 Alphabetic List of Variables and Attributes Standard Research File One of these three variables must be suppressed (diag1, fac, or
More informationSCIP-Inf-2, SCIP-Inf-3, SCIP-Inf-4, SCIP-Inf- 9, SCIP-Inf-10, SCIP-VTE-1, SCIP-VTE-2 Anesthesia End Time 5
Release Notes: Alphabetical Data Dictionary Version 3.3 Surgical Care Improvement Project (SCIP) - Data Dictionary The General Abstraction Guidelines explain the different sections of the data element
More informationNEW JERSEY HOSPITAL PERFORMANCE REPORT 2012 DATA PUBLISHED 2015 TECHNICAL REPORT: METHODOLOGY RECOMMENDED CARE (PROCESS OF CARE) MEASURES
NEW JERSEY HOSPITAL PERFORMANCE REPORT 2012 DATA PUBLISHED 2015 TECHNICAL REPORT: METHODOLOGY RECOMMENDED CARE (PROCESS OF CARE) MEASURES New Jersey Department of Health Health Care Quality Assessment
More informationOutpatient Quality Reporting Program
Hospital Outpatient Quality Reporting (OQR) Program 2018 Specifications Manual Update Questions & Answers Moderator: Pam Harris, BSN, RN Project Coordinator, Education and Speaker: Melissa Thompson, BSN,
More informationMinnesota Statewide Quality Reporting and Measurement System: Appendices to Minnesota Administrative Rules, Chapter 4654
This document is made available electronically by the Minnesota Legislative Reference Library as part of an ongoing digital archiving project. http://www.leg.state.mn.us/lrl/lrl.asp Minnesota Statewide
More informationHIT Incentives: Issues of Concern to Hospitals in the CMS Proposed Meaningful Use Stage 2 Rule
HIT Incentives: Issues of Concern to Hospitals in the CMS Proposed Meaningful Use Stage 2 Rule Lori Mihalich-Levin, J.D. lmlevin@aamc.org; 202-828-0599 Jennifer Faerberg jfaerberg@aamc.org; 202-862-6221
More informationHospital Value-Based Purchasing (At a Glance)
Hospital Value-Based Purchasing (At a Glance) Healthcare Financial Management Association South Carolina Chapter March 20, 2012 Presenters: Linda Moore, RN, Manager of Federal Programs and Services, CCME
More informationMinnesota Statewide Quality Reporting and Measurement System: Appendices to Minnesota Administrative Rules, Chapter 4654
This document is made available electronically by the Minnesota Legislative Reference Library as part of an ongoing digital archiving project. http://www.leg.state.mn.us/lrl/lrl.asp Minnesota Statewide
More informationTroubleshooting Audio
Welcome! Presentation slides can be downloaded from www.qualityreportingcenter.com under Upcoming Events on the right-hand side of the page. Audio for this event is available via ReadyTalk Internet streaming.
More informationRural-Relevant Quality Measures for Critical Access Hospitals
Rural-Relevant Quality Measures for Critical Access Hospitals Ira Moscovice PhD Michelle Casey MS University of Minnesota Rural Health Research Center Minnesota Rural Health Conference Duluth, Minnesota
More informationOP ED-THROUGHPUT GENERAL DATA ELEMENT LIST. All Records
Material inside brackets ( [ and ] ) is new to this Specifications Manual version. HOSPITAL OUTPATIENT QUALITY MEASURES ED-Throughput Set Measure ID # OP-18 OP-20 OP-22 Measure Short Name Median Time from
More informationOP ED-Throughput General Data Element List. All Records All Records. All Records All Records All Records. All Records. All Records.
Material inside brackets ([and]) is new to this Specifications Manual version. Hospital Outpatient Quality Measures ED-Throughput Set Measure ID # OP-18 OP-20 OP-22 Measure Short Name Median Time from
More informationFormat Specifications For the MHA DMS Publish Date: 11/20/2017
Specifications For the MHA DMS 10 1.00.10 Publish Date: 11/20/2017 This document is updated periodically. If you are not reading this on the web but are instead reading a printed copy, please check our
More informationGender. Age DEMOGRAPHICS POINTS OF DISTINCTION COMISSION FOR ACCREDITATION OF REHABILITATION FACILITIES STATE OF FLORIDA BRAIN AND SPINAL CORD PROGRAM
POINTS OF DISTINCTION 89-bed Acute Adult Inpatient Rehabilitation Unit, All private rooms 4 th largest Rehabilitation provider in the state of Florida Admitted 2157 patients from April 2017 through March
More information2006 Clinical Coding Workout 5/3/2006 MISSING QUESTIONS Chapter 5, Intermediate Ambulatory Page 1
Chapter 5, Intermediate Ambulatory Page 1 CPT Modifier Use 5.81. Dr. Raddy, staff radiologist, interprets a chest x-ray that was obtained in the hospital Radiology Department. Dr. Raddy is contracted with
More informationMinnesota Statewide Quality Reporting and Measurement System: Appendices to Minnesota Administrative Rules, Chapter 4654
Minnesota Statewide Quality Reporting and Measurement System: Appendices to Minnesota Administrative Rules, Chapter 4654 Minnesota Department of Health October 2011 Division of Health Policy Health Economics
More informationMBQIP Measures Fact Sheets December 2017
December 2017 This project is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number U1RRH29052, Rural Quality
More informationOutpatient Quality Reporting Program
The Question and Answer Show Moderator: Karen VanBourgondien, BSN, RN Speaker(s): Pam Harris, BSN, RN June 21, 2017 10:00 am Isn't Q2 submission due August 1, 2017? August 1, 2017 deadline is for Quarter
More informationReducing Readmissions One-caseat-a-time Using Midas+ Community Case Management
Reducing Readmissions One-caseat-a-time Using Midas+ Community Case Management John Playford, Senior Midas+ Solutions Advisor Barb Craig, Midas+ SaaS Advisor The Problem Historically, up to 25% of patients
More information3 SCIP-Inf-2, SCIP-Inf-3, SCIP-Inf-4, SCIP-Inf-9, SCIP-Inf-10, SCIP-VTE-1, SCIP-VTE-2 Anesthesia End Time
Release Notes: Alphabetical Data Dictionary Version 3.0b Surgical Care Improvement Project (SCIP) - Data Dictionary The General Abstraction Guidelines explain the different sections of the data element
More informationMBQIP Quality Measure Trends, Data Summary Report #20 November 2016
MBQIP Quality Measure Trends, 2011-2016 Data Summary Report #20 November 2016 Tami Swenson, PhD Michelle Casey, MS University of Minnesota Rural Health Research Center ABOUT This project was supported
More informationEffective Use of Existing Licensed Healthcare Infrastructure During a Crisis or Catastrophe
Effective Use of Existing Licensed Healthcare Infrastructure During a Crisis or Catastrophe Kathy McCanna, Program Manager-Office of Medical Facilities Connie Belden, Team Leader-Office of Medical Facilities
More informationPopulation and Sampling Specifications
Mat erial inside brac ket s ( [ and ] ) is new to t his Specific ati ons Manual versi on. Introduction Population Population and Sampling Specifications Defining the population is the first step to estimate
More informationPresented by: Gara Edelstein, CNO, CHS & St. Catherine of Siena Nicolette Fiore-Lopez, CNO, St. Charles Hospital Susan Penque, CNO, South Nassau
Presented by: Gara Edelstein, CNO, CHS & St. Catherine of Siena Nicolette Fiore-Lopez, CNO, St. Charles Hospital Susan Penque, CNO, South Nassau Communities Hospital Valerie Terzano, CNO, Winthrop University
More informationMEDICARE BENEFICIARY QUALITY IMPROVEMENT PROJECT (MBQIP)
MEDICARE BENEFICIARY QUALITY IMPROVEMENT PROJECT (MBQIP) Began in September 2011 Key quality improvement activity within the Medicare Rural Hospital Flexibility grant program Goal of MBQIP: to improve
More informationHospital Compare Quality Measure Results for Oregon CAHs: 2015
KEY FINDINGS: Flex Monitoring Team STATE DATA REPORT February 2017 Hospital Compare Quality Measure Results for Oregon : 2015 Michelle Casey, MS; Tami Swenson, PhD; Alex Evenson, MA University of Minnesota
More informationTips for Completing the UB04 (CMS-1450) Claim Form
Tips for Completing the UB04 (CMS-1450) Claim Form As a Beacon facility partner, we value the services you provide and it is important to us that you are reimbursed for the work you do. To assure your
More informationExecutive Summary MEDICARE FEE-FOR-SERVICE (FFS) HOSPITAL READMISSIONS: QUARTER 4 (Q4) 2012 Q STATE OF CALIFORNIA
MEDICARE FEE-FOR-SERVICE (FFS) HOSPITAL READMISSIONS: QUARTER 4 (Q4) 2012 Q3 2013 Executive Summary STATE OF CALIFORNIA The Centers for Medicare & Medicaid Services (CMS) has tasked Health Services Advisory
More informationHospital Outpatient Quality Measures. Kathy Wonderly RN, MSEd, CPHQ Consultant Developed: January, 2018
Hospital Outpatient Quality Measures Kathy Wonderly RN, MSEd, CPHQ Consultant Developed: January, 2018 Background Hospitals have separate quality measures for the outpatient population. These measures
More information2015 Physician Licensure Survey
2015 Physician Licensure Survey 1. What is your racial background? Please select all that apply. White American Indian or Alaska Native Native Hawaiian/Pacific Islander Black or African American Asian
More informationCME Disclosure. HCAHPS- Hardwiring Your Hospital for Pay-for-Performance Success. Accreditation Statement. Designation of Credit.
CME Disclosure Accreditation Statement Studer Group is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. Designation
More informationCarolinas Collaborative Data Dictionary
Overview Carolinas Collaborative Data Dictionary This data dictionary is intended to be a guide of the readily available, harmonized data in the Carolinas Collaborative Common Data Model via i2b2/shrine.
More informationCareFirst ICD-10 Claim Submission Guidelines
CareFirst ICD-10 Claim Submission Guidelines Introduction The U.S. Department of Health and Human (HHS) has released a HIPAA administration simplification mandate requiring all HIPAA entities to adopt
More informationCMS in the 21 st Century
CMS in the 21 st Century ICE 2013 ANNUAL CONFERENCE David Saÿen, MBA Regional Administrator Centers for Medicare & Medicaid Services San Francisco November 15, 2013 The strategy is to concurrently pursue
More informationUsing Clinical Criteria for Evaluating Short Stays and Beyond. Georgeann Edford, RN, MBA, CCS-P. The Clinical Face of Medical Necessity
Using Clinical Criteria for Evaluating Short Stays and Beyond Georgeann Edford, RN, MBA, CCS-P The Clinical Face of Medical Necessity 1 The Documentation Faces of Medical Necessity ç3 Setting the Stage
More informationMinnesota Statewide Quality Reporting and Measurement System: Appendices to Minnesota Administrative Rules, Chapter 4654
This document is made available electronically by the Minnesota Legislative Reference Library as part of an ongoing digital archiving project. http://www.leg.state.mn.us/lrl/lrl.asp Minnesota Statewide
More information2) The percentage of discharges for which the patient received follow-up within 7 days after
Quality ID #391 (NQF 0576): Follow-Up After Hospitalization for Mental Illness (FUH) National Quality Strategy Domain: Communication and Care Coordination 2018 OPTIONS FOR INDIVIDUAL MEASURES: REGISTRY
More informationDischarge checklist and follow-up phone calls: the foundation to an effective discharge process
Discharge checklist and follow-up phone calls: the foundation to an effective discharge process Shari Aman, BSN, RN, MBA, CPHQ Denise Andrews, MBA Stephanie Storie, BSN, RN, CMSRN Deb Nation, RN, CMSRN
More informationHospital Outpatient Quality Reporting Program
Hospital Outpatient Quality Reporting Program Support Contractor OQR 2016 Specifications Manual Update Questions & Answers Moderator: Pam Harris, BSN Speakers: Nina Rose, MA Samantha Berns, MSPH Bob Dickerson,
More informationOutpatient Quality Reporting Program
OQR 2016 Specifications Manual Update Questions & Answers Moderator: Pam Harris, BSN Speakers: Nina Rose, MA Samantha Berns, MSPH Bob Dickerson, HSHSA, RRT Angela Merrill, PhD Colleen McKiernan, MSPH,
More informationMEDICAL POLICY No R1 TELEMEDICINE
Summary of Changes MEDICAL POLICY TELEMEDICINE Effective Date: March 1, 2016 Review Dates: 12/12, 12/13, 11/14, 11/15 Date Of Origin: December 12, 2012 Status: Current Clarifications: Deletions: Pg. 4,
More informationElectronic Patient Record (EPR) and Public Reporting
Electronic Patient Record (EPR) and Public Reporting Elisa L. Horbatuk, MA Data Manager, Decision Support Services Stony Brook University Medical Center MIT Information Quality Industry Symposium July,
More informationThe dawn of hospital pay for quality has arrived. Hospitals have been reporting
Value-based purchasing SCIP measures to weigh in Medicare pay starting in 2013 The dawn of hospital pay for quality has arrived. Hospitals have been reporting Surgical Care Improvement Project (SCIP) measures
More informationHome Health Quality Improvement Campaign
Home Health Quality Improvement Campaign Description of Monthly Report for Improvement in Oral Medications Monthly Report for Improvement in Management of Oral Medications All data displayed illustrate
More informationInformation for Skilled Nursing Facilities, Hospice R&B Providers & Supportive Living Programs: Authorizations, Billing and Claims
Information for Skilled Nursing Facilities, Hospice R&B Providers & Supportive Living Programs: Authorizations, Billing and Claims Skilled Nursing Facility Services Custodial Care, SLP and Hospice R&B
More informationEPIC-Midas+ Integration
EPIC-Midas+ Integration Marie C. Geraci Midas+ Integration Analyst Medical Record Number (MRN): The MRN is a unique identifier assigned to each patient record. Hospital Account (HAR): The hospital account
More informationMEDICARE ENROLLMENT, HEALTH STATUS, SERVICE USE AND PAYMENT DATA FOR AMERICAN INDIANS & ALASKA NATIVES
American Indian & Alaska Native Data Project of the Centers for Medicare and Medicaid Services Tribal Technical Advisory Group MEDICARE ENROLLMENT, HEALTH STATUS, SERVICE USE AND PAYMENT DATA FOR AMERICAN
More informationQuality Care Amongst Clinical Commotion: Daily Challenges in the Care Environment
Quality Care Amongst Clinical Commotion: Daily Challenges in the Care Environment presented by Sherry Kwater, MSM,BSN,RN Chief Nursing Officer Penn State Hershey Medical Center Objectives 1. Understand
More informationTHE ART OF DIAGNOSTIC CODING PART 1
THE ART OF DIAGNOSTIC CODING PART 1 Judy Adams, RN, BSN, HCS-D, HCS-O June 14, 2013 2 Background Every health care setting has gone through similar changes in the need to code more thoroughly. We can learn
More informationMEDICARE CCLF ANALYTICS: MEDICARE ANALYTICS DATA ENGINE (MADE)
MEDICARE CCLF ANALYTICS: MEDICARE ANALYTICS DATA ENGINE (MADE) Frequently Asked Questions 1.2 November 13, 2017 hmetrix hmetrix This document contains frequently asked questions regarding the utility,
More informationMEDICAL POLICY No R2 TELEMEDICINE
Summary of Changes Clarifications: Page 1, Section I. A 6, additional language added for clarification. Deletions: Additions Page 4, Section IV, Description, additional language added in regards to telemedicine.
More informationObjectives. Integrating Performance Improvement with Publicly Reported Quality Metrics, Value-Based Purchasing Incentives and ISO 9001/9004
Integrating Performance Improvement with Publicly Reported Quality Metrics, Value-Based Purchasing Incentives and ISO 9001/9004 Session: C658 2013 ANCC National Magnet Conference Thursday, October 3, 2013
More information2017 SPECIALTY REPORT ANNUAL REPORT
2017 SPECIALTY REPORT ANNUAL REPORT National Commission on Certification of Physician Assistants Table of Contents Message from the President... 3 About the Data Collection and Methodology...4 All Specialties....
More informationHospital Outpatient Quality Reporting Back to the Basics: Critical Access Hospitals
Hospital Outpatient Quality Reporting Back to the Basics: Critical Access Hospitals Sophia Cherry, RPh, MPH Quality Improvement Specialist Health Services Advisory Group (HSAG) November 9, 2017 HSAG and
More informationNational Priorities for Improvement:
National Priorities for Improvement: Standardization of Performance Measures, Data Collection, and Analysis Dale W. Bratzler, DO, MPH Principal Clinical Coordinator Oklahoma Foundation Contracting for
More informationNOTE: New Hampshire rules, to
NOTE: New Hampshire rules, 309.01 to 309.08 Email Request: Selected Items in Table of Contents: (8) Time Of Request: Sunday, August 07, 2011 18:11:07 EST Send To: MEGADEAL, ACADEMIC UNIVERSE UNIVERSITY
More informationMedicare Value-Based Purchasing for Hospitals: A New Era in Payment
Medicare Value-Based Purchasing for Hospitals: A New Era in Payment Daniel J. Hettich March, 2012 I. Introduction: Evolution of Medicare as a Purchaser Cost reimbursement rewards furnishing more services
More informationOlutoyin Abitoye, MD Attending, Department of Internal Medicine Virtua Medical Group New Jersey,USA
Olutoyin Abitoye, MD Attending, Department of Internal Medicine Virtua Medical Group New Jersey,USA Introduce the methods of using core measures to compare quality of health care US hospitals provide Have
More informationAn Overview of the. Measures. Reporting Initiative. bwinkle 11/12
An Overview of the National Hospital Quality Measures A National Voluntary Hospital Reporting Initiative bwinkle 11/12 What Are Hospital Quality Measures? The Joint Commission (TJC) and the Centers for
More informationAugust 1, 2012 (202) CMS makes changes to improve quality of care during hospital inpatient stays
DEPARTMENT OF HEALTH & HUMAN SERVICES Centers for Medicare & Medicaid Services Room 352-G 200 Independence Avenue, SW Washington, DC 20201 FACT SHEET FOR IMMEDIATE RELEASE Contact: CMS Media Relations
More informationEvaluation and Management
Evaluation and Management CPT CPT copyright 2011 American Medical Association. All rights reserved. Fee schedules, relative value units, conversion factors and/or related components are not assigned by
More informationCommunity Performance Report
: Wenatchee Current Year: Q1 217 through Q4 217 Qualis Health Communities for Safer Transitions of Care Performance Report : Wenatchee Includes Data Through: Q4 217 Report Created: May 3, 218 Purpose of
More informationUB-92 Billing Instructions
August 26, 2005 UB-92 Billing Instructions 2005 Hospital Provider Workshop Conduent MS Medicaid Project Government Healthcare Solutions Objective & Definition To explain how to complete a UB-92 claim form
More informationCoding Implications of Coding Medical Necessity and Core Measures. Medical Necessity. NCHIMA Coding Roundtable Webinar.
Coding Implications of Coding Medical Necessity and Core Measures NCHIMA Coding Roundtable Webinar February 20, 2013 Kou Yang, RHIA Sharon Easterling, MHA, RHIA, CCS, CDIP, CPHM February 2013 Medical Necessity
More informationRefining and Field Testing a Relevant Set of Quality Measures for Rural Hospitals Final Report June 30, 2005
Refining and Field Testing a Relevant Set of Quality Measures for Rural Hospitals Final Report June 30, 2005 A Joint Collaborative Between: Rural Health Research Center Division of Health Services Research
More informationAn Illustration in CLAS Bringing the Cultural and Linguistic Service Standards to Life
July 25, 2015 Health Forum and Leadership Summit San Francisco, California An Illustration in CLAS Bringing the Cultural and Linguistic Service Standards to Life Juana S. Slade, CDM, CCF, Chief Diversity
More informationStandardized Performance Measures for Advanced Certification in Heart Failure
Standardized Performance Measures for Advanced Certification in Heart Failure Karen Kolbusz, RN, BSN, MBA Associate Project Director Division of Healthcare Quality Evaluation The Joint Commission Objectives
More informationHOW TO SUBMIT OWCP-04 BILLS TO ACS
HOW TO SUBMIT OWCP-04 BILLS TO ACS The following services should be billed on the OWCP-04 Form: General Hospital Hospice Nursing Home Rehabilitation Centers As a provider you have the option of sending
More informationPrior Authorization form for Post-Acute Care Admission and Recertification for SNF,LTAC and Rehab
Prior Authorization form for Post-Acute Care Admission and Recertification for SNF,LTAC and Rehab (Required for all Rehab, SNF, LTAC admits) Providers must request authorization for initial admissions
More informationTransitioning to the New IRF-PAI
Transitioning to the New IRF-PAI 2014. FIM, UDS-PROi, UDSMR, and the UDSMR logo are trademarks of, a division of UB Foundation Activities, Inc. Agenda August 2014 final rule summary Discuss IRF PPS changes
More informationQuality and Health Care Reform: How Do We Proceed?
Quality and Health Care Reform: How Do We Proceed? Susan D. Moffatt-Bruce, MD, PhD Chief Quality and Patient Safety Officer Associate Dean of Clinical Affairs Quality and Patient Safety Associate Professor
More informationNational Provider Call: Hospital Value-Based Purchasing
National Provider Call: Hospital Value-Based Purchasing Fiscal Year 2015 Overview for Beneficiaries, Providers, and Stakeholders Centers for Medicare & Medicaid Services 1 March 14, 2013 Medicare Learning
More informationPlace of Service Code Description Conversion
Place of Conversion CMS Place of Code Place of Name The place of service field indicates where the services were performed Possible values include: Code Description Inpatient Outpatient Office Home 5 Independent
More informationDeleted Codes. Agenda 1/31/ E/M Codes Deleted Codes New Codes Changed Codes
February 2013 Jean C. Russell, MS, RHIT jrussell@epochhealth.com Richard Cooley, BA, CCS rcooley@epochhealth.com 518-430-1144 2 2013 E/M Codes Deleted Codes New Codes Changed Codes Agenda Documentation
More informationFebruary Jean C. Russell, MS, RHIT Richard Cooley, BA, CCS
February 2013 Jean C. Russell, MS, RHIT jrussell@epochhealth.com Richard Cooley, BA, CCS rcooley@epochhealth.com 518-430-1144 2 2013 E/M Codes Deleted Codes New Codes Changed Codes Agenda Documentation
More informationMedicare P4P -- Medicare Quality Reporting, Incentive and Penalty Programs
Medicare P4P -- Medicare Quality Reporting, Incentive and Penalty Programs Presenter: Daniel J. Hettich King & Spalding; Washington, DC dhettich@kslaw.com 1 I. Introduction Evolution of Medicare as a Purchaser
More informationModel VBP FY2014 Worksheet Instructions and Reference Guide
Model VBP FY2014 Worksheet Instructions and Reference Guide This material was prepared by Qualis Health, the Medicare Quality Improvement Organization for Idaho and Washington, under a contract with the
More informationPossible Denominator Codes Applicable to OMS * Le Fort Fractures 21346, 21347, 21348, 21422, 21423, 21432, 21433, 21435, 21436
Individual PQRS s Eligible OMS #20: #22: Perioperative Care: Timing of Antibiotic Prophylaxis Ordering Physician. Percentage of surgical patients aged 18 years and older undergoing procedures with the
More informationCCU Data Collection with MIDAS+
May 22 24, 2006 Starr Pass Resort Tucson, Arizona CCU Data Collection with MIDAS+ This session will examine the task of collecting and aggregating CCU data and present the best method for accomplishing
More informationOutpatient Quality Reporting Program
The Abstraction Challenge Show: Real Questions, Real Presentation Transcript Moderator: Karen VanBourgondien, BSN, RN Hospital OQR Program Speaker: Hospital OQR Program Support Contactor Team Hospital
More information