CMS Releases 2013 IPPS Final Rule

HAC list

CMS finalized the addition of two conditions to the HAC list:

• Surgical site infection following cardiac implantable electronic device (CIED)
• Iatrogenic pneumothorax with venous catheterization

Both conditions, as reported, are currently CCs, Gold notes.

Inpatient facilities do not receive higher MS-DRG payments for patients with CCs or MCCs caused by of the conditions on the HAC list if no other CCs or MCCs are present. CMS also reiterated that conditions on the HAC list that are not present on admission will not be paid as CC or MCC, says Gold.

Hospitals will need to ascertain that they code 38.93 (venous catheterization not elsewhere classified) on all patients whereby a central line is placed so that this HAC will be appropriately identified, Kennedy emphasized.

CMS also added the following two codes to the existing vascular catheter-associated infection HAC category:

• 999.32 (bloodstream infection due to central catheter)
• 999.33 (local infection due to central venous catheter)

The focus has been on identifying conditions that occur while the patient is in the hospital that are going to impact reimbursement (cause Medicare to pay more) and can be prevented through evidence-based guidelines, says Jennifer Avery, CCS, CPC-H, CPC, CPC-I, regulatory specialist for HCPro, Inc, in Danvers, Mass. "I am in total agreement that the government should not pay for hospitals to provide less than quality care to any patient. We shouldn't reward hospitals to make mistakes and I believe we will see more conditions added as they are identified."