NEWS YOU CAN USE: Prevent Surgical Infections and Receive Incentive Payments

• Check out these new hospital quality measures
How well your hospital provides prevention measures for surgical infections and pneumonia could determine whether you’ll receive incentive payments.
On Sept. 2, CMS and the Hospital Quality Alliance (HQA) released new quality information on the Hospital Compare Web site about increases in hospital reporting and new quality measures. CMS added two new surgical infection prevention measures and a new pneumonia measure. These additions bring the total number of measures to 20, “including the 10 clinical measures that short-term acute-care hospitals must agree to report publicly in order to receive the incentive payments,” the agency says.
The Surgical Care Improvement Project (SCIP) spurred the new surgical infection prevention measures. SCIP’s goal is to reach a 25 percent reduction in postoperative complications by 2010, CMS says.
Plus: More than 90 percent of participating hospitals are reporting on at least the 10 “starter set” of measures, and more than 70 percent are reporting all 17 of the quality measures. “While it is too early to determine any major trends in hospital performance on the measures, the latest information makes it even clearer that there are important opportunities for quality improvement,” says CMS Administrator Mark McClellan.
For more information on hospital quality data and the new measures, go to http://www.hospitalcompare.hhs.gov or http://www.medicare.gov.



• Report the right HCPCS codes for devices 
 
When Medicare lists several device codes for a procedure, you need to list only one of the possible device codes to receive payment.
The CMS revised its guidelines in an Aug. 26 transmittal for hospitals that bill procedures that require devices under the outpatient prospective payment system (OPPS). Effective Oct. 1, 2005, hospitals that bill under the OPPS must report the appropriate healthcare common procedure coding system (HCPCS) codes and charges for devices that a healthcare professional uses during a procedure.
Hospitals need to go online to http://www.cms.hhs.gov/medicare/HCPCS and and also visit http://www.cms.hhs.gov/providers/hopps on the CMS Web site to stay up-to-date on current HCPCS device codes--or they could face returned claims, CMS says. When a hospital submits a claim that contains a procedure code that supports one or more device codes, the facility must report at least one of the device HCPCS codes on the claim.
Important: These requirements don’t apply when a procedure is interrupted before the healthcare professional uses the device. In such cases, you can report the procedure code--without the device code--and append it with one of the following modifiers: modifier 52 (Reduced services), modifier 73 (Discontinued outpatient procedure prior to anesthesia administration), and modifier 74 (... after anesthesia administration).
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- Published on 2005-10-11