OIG: Hospitals err 18% of the time with point-of-admission indicators

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Urinary tract infections, pneumonia and blood infections were among the top developing conditions given inaccurate detection indicators when Medicare patients were admitted to the hospital, a government report finds.

A lack of uniformity among hospital coders for developing conditions is a main reason for the “point of admission” errors, according to a Monday report from the Department of Health and Human Services Office of Inspector General.

The investigators reviewed nearly 700 claims that included almost 5,500 POA indicators and discovered 180 POA errors. That mean nearly 1 in 5 (18%) experienced an error. They also found cases where the indicators were not correct for a patient with a chronic condition, such as diabetes or congestive heart failure.

The Centers for Medicare & Medicaid requires POA indicators in order to distinguish which problems appeared after being admitted, such as hospital-acquired infections, which may change the reimbursement amount given to a hospital.

Click here to see the report.

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