>96 hours ventilation

kshumpert

Good morning everyone! We have started to receive audits from NGS for >96 hours ventilation procedure 96.72, and sent our first chart out this week. I didn't find any documentation or coding issues with the chart. This morning I learned that one of our pulmonologists knows what Medicare is looking for! He has developed a protocol [insert humor and some tears...] I have a meeting Friday with our CMO so that I may swiftly write this protocol:) Although I greatly appreciate his involvement and interest, I also know that preference don't always establish the best practice. So, does anyone have any type of protocol, query, policy or reference you use for >96 hours ventilation? I already met with respiratory therapy and went over documentation with them. I appreciate any input as always. Have a great day everyone!

cstukenberg

My question is: Was the person on the vent >96 hours. IF so, what is NGS looking for?

kshumpert

Well, that is a good question. The patient was on the vent >96 hours. All documentation looks good; additionally our pulmonologists have gone through documentation reviews previously and try to capture the SOI/ROM as intensivists. NGS has only requested documentation related to the ventilation, ie. ER record, H&P, consultations, progress notes, orders, and respiratory therapy notes. I could not determine from the documentation request letter what the true issues were -unlike a RAC audit that indicates what the issue are. I check the NGS website and really did not get much detail other than audit for 96.72 had previously occurred in New York, but nothing indicating the findings other than $$$$$. Unlike RACs, NGS had a statement that said if they found any additional issues with the chart while auditing it, they would address those. So, we did a complete chart audit and sent it out.

Thanks,
Kathy
Kathy Shumpert, RN, CCDS

Clinical Documentation Improvement Specialist
Howard Regional Health System
Office 765-864-8754
Cell phone 765-432-3961
Fax 765-453-8447

When something can be read without effort, great effort has gone into its writing. ~Enrique Jardiel Poncela

jamiedugan2012

What does NGS stand for?

sharon.cooper@owensborohealth.org

National Government Services


Confidentiality Notice: This message, including any attachments, is for the sole use of the intended recipients(s) and may contain confidential and privileged information. Any unauthorized review, use, disclosure or distribution is prohibited. If you are not the intended recipient, please contact the sender via E-mail and destroy all copies of the original message.

cstukenberg

Then not sure what they are looking for or their intent.

jamiedugan2012

Thanks for the heads up, I let our auditor know. Interesting If you find
out more let us know!

Unknown

We received audits for that DRG and it is my understanding that they are looking for an appropriate calculation of vent hours. We discovered we did not have clear documentation of extubation times. We clarified this with our respiratory department who adjusted their documentation screens to now include the extubation time.

Lisa McLuckie RN

Clinical Documentation Specialist

Wooster Community Hospital

evanspx@sutterhealth.org

Often the issue with MV is the 'counting of the hours'. The coding
staff should carefully review the flow sheets to ensure the proper
numberof hours are coded in order to report the proper MS-DRG for those
cases whereby MV is a factor in DRG Assignment.

It can be very tedious, and during some audits, I have found some that
simply count the 'days', rather than the hours. It can make a
difference.

Paul Evans, RHIA, CCS, CCS-P, CCDS

Supervisor, Clinical Documentation Integrity, Quality Department
California Pacific Medical Center
2351 Clay #243
San Francisco, CA 94115
Cell: 415.637.9002
Fax: 415.600.1325
Ofc: 415.600.3739
evanspx@sutterhealth.org