Has anyone heard of a CMS Capture Rate?
Someone asked about a CMS capture rate. I have heard of a facility specific CC and MCC capture rate but not a CMS capture rate.
The CDI Bootcamp mentions 40% CC rate based on MS-DRGs.
Does anyone else have any other thoughts?
Thanks.
Charlie Morell
The CDI Bootcamp mentions 40% CC rate based on MS-DRGs.
Does anyone else have any other thoughts?
Thanks.
Charlie Morell
Comments
Are you meaning a CC/MCC capture rate for Medicare patients only?
We get that from our consulting company. Also PEPPER would have that info as well.
I am not sure I am on the right track on what you are asking?
Katy Good, RN, BSN, CCDS, CCS
Clinical Documentation Program Coordinator
AHIMA Approved ICD-10CM/PCS Trainer
Flagstaff Medical Center
Kathryn.Good@nahealth.com
Cell: 928.814.9404
http://blogs.hcpro.com/acdis/2012/11/tip-use-ipps-data-for-your-cdi-program-benchmarking/
Using Table 7 of the final rule (provides the total number of cases NATIONALLY for each DRG -- final rule FY15 would be FY13 medpars data set).
From that post, for ex, Triplet cases (all -- both med & surg) (probably final rule FY11 or 12, so dated)
w/MCC 32%, w/cc 45%, none 23%
To do this does take some prep work on the Table -- categorizing each DRG into: Pair CC/MCC Pair No CC/MCC Pair MCC Pair No MCC Triplet MCC Triplet CC Triplet None; easiest to add that to the Table in the final rule that lists all of the DRGs, since that already has the Med/Surg/Pre designation.
The Pepper report is probably the best/easiest source, but does not give the ability to look specifically at certain DRG sets (CHF, sepsis or hips for example) capture rates.
PEPPER additionally also gives a look at ratios, for example simple PNA vs complex which is useful to reflect upon. Can develop similar ratios from Table 7 if there is an area of specific interest.
Don
Donald A. Butler, RN, BSN
Manager, Clinical Documentation Advisor Program
Vidant Health, Greenville NC
DButler@vidanthealth.com ( mailto:mDButler@vidanthealth.com )