FEATURE
the new quality measures, to determine which patients must be included in re- porting. Documentation technology can also provide automated remind- ers to facility staff about what type of information to capture and when this information should be submitted to en- sure that reimbursements are received. It can also make it easier for facilities to measure the quality of services and performance necessary to achieve ac- creditation and streamline everyday processes for staff and patients alike. The benefits of documentation tech-
Caption to come. Lenia adi as eum explabore, aut. Pari aut quat estectur?
Technology can help. BY LINDSAY MCQUEENEY HANRAHAN Documentation Overload?
New legislative and regula- tory requirements intended to control costs and improve quality of care are quickly changing the ASC indus-
try. While the go-live date is still pend- ing for many of these regulations, their impact is already being felt as docu- mentation requirements are becoming increasingly complex. Facilities failing to report the required data, at the right intervals, will lose money, while those unable to demonstrate the appropriate documentation upon request run the risk of non-compliance, which can re- sult in fines. With the recent introduction of Medi-
care’s Ambulatory Surgical Center Qual- ity Reporting (ASCQR) Program, which requires ASCs to report quality data G- codes on five predefined measures, the first of several major changes is underway. To meet the requirements for this new rule, ASCs must implement G-code quality
reporting measures on these events or face future Medicare payment reduc- tions. In July, the Centers for Medicare & Medicaid Services (CMS) issued a proposal that includes four new qual- ity measures that focus primarily on follow-up processes after certain pro- cedures and specific patient outcomes measures. In terms of reporting, this is just the beginning. Significantly more detailed
documentation and coding
will be required again on October 1, 2014, when the International Classi- fication of Diseases, Tenth Revision (ICD-10) takes effect. Technology will play a key role in a
provider’s ability to meet these contin- ually evolving reporting requirements. Without the proper documentation software in place, it will be nearly im- possible for providers to keep track of every detail and requirement for each program, the corresponding codes and reporting intervals, and in the case of
22 ASC FOCUS NOVEMBER/DECEMBER 2013
nology are plenty. Yet it is important to note that not all applications/systems are created equal. To help staff select the software that best fits their facil- ity’s needs, consider the following:
Can the application/system support both ICD-9 and ICD-10 diagnosis
codes?
It is important to make sure the system selected can support both ICD-9 and ICD-10 code sets going for- ward because there is a carve-out that allows entities that are not covered by the Health Insurance Portability and Accountability Act of 1996 (HIPAA), such as attorneys and workers’ com- pensation programs, to continue to use ICD-9 code sets going forward.
Can the application/system ensure the appropriate diagnosis code
set is used for each payer? More than simply supporting both ICD-9 and ICD-10 diagno-
sis codes, the system selected should offer some sort of mechanism that alerts users to which of those two code sets should be selected for each payer. Otherwise, the wrong code will cause claims to be rejected and pay- ments delayed. The system should also allow ICD-9 options to be phased out as payers transition to ICD-10.
The advice and opinions expressed in this article are those of the author and do not represent official Ambulatory Surgery Center Association policy or opinion.
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