CMI question

katysuegood@gmail.comkatysuegood@gmail.com
in CDI Talk Archive
Be forewarned, I feel like this is a dumb question, forgive me ;-)

When we are talking about 'CMI', are we talking only about patients that are:

1. Medicare only

2. Medicare and other DRG payers (BCBS, etc)

3. All inpatients

4. Other?
Thanks!

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

Comments

  • annnd2009@gmail.comannnd2009@gmail.com
    edited April 2016
    I won’t claim to be an expert (by any stretch) but I thought it was all discharges…
    http://www.jblearning.com/samples/0763750344/45561_ch01.pdf



    Ann Donnelly,RN,BSN,CCDS
    annnd2009@gmail.com
  • karenmpukarenmpu
    edited April 2016
    Katy,

    There are no dumb questions!!

    The CMI is used for inpatients, and after that, one can calculate a CMI according to any payer population (or groups of payer populations) they wish. Therefore, it is a good idea to ask which payer(s) was(were) used in the calculation when in a discussion regarding CMI.

    Good question!!
    Karen

    Karen Newhouser, RN, BSN, CCDS, CCS, CCM
    Director of CDI Education
    MedPartners CDI
    Cellular: 937-620-2788
    KarenMPU@medpartnershim.com
    www.medpartnershim.com
    Rapid Response. Proven Talent. Exceptional Service.


  • karenmpukarenmpu
    edited April 2016
    Good question! The Finance Department handles the requests for how the CMI is reported. Unfortunately, I didn't have hands on with that process. Perhaps someone else can weigh in on this?

    Thanks,
    Karen

    Karen Newhouser, RN, BSN, CCDS, CCS, CCM
    Director of CDI Education
    MedPartners CDI
    Cellular: 937-620-2788
    KarenMPU@medpartnershim.com
    www.medpartnershim.com
    Rapid Response. Proven Talent. Exceptional Service.


  • evanspx@sutterhealth.orgevanspx@sutterhealth.org
    edited April 2016
    Typically, the Finance Dept at each site works with the IT team to ensure the proper rates are loaded. Finance knows the various components of the financial formula, and then the IT team will need to update several data fields in the Software Logic. I have used many software companies, and typically, they do not know the precise and unique rates specific for each site as these rates are set by CMS with a unique rate given for each site, based on Provider ID.

    PE

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

    Manager, Regional Clinical Documentation & Coding Integrity
    Sutter West Bay
    633 Folsom St., 7th Floor, Office 7-044
    San Francisco, CA 94107
    Cell: 415.412.9421

  • ssalinasssalinas
    edited April 2016
    3M software has the formula built into the grouper but we have to input the hospital specific values in the configuration file. Not sure about other groupers.

    It also depends on what grouper package your facility has. We have the IPPS MS-DRG Grouper, the LTCH MS-DRG Grouper and the California APR-DRG grouper. I enter hospital specific values for each of these. The MS-DRG values come from CMS. The APR-DRG values come from the state.

    We have Meditech and our CMS rate has to be entered there if we want it to calculate the reimbursement based on MS-DRGs. We do not use MT for calculating any other types of payment on the coding side. The billing side does calculate based on per diems etc but that has nothing to do with coding or the group[er.

    Hope this helps?

    Sharon Salinas, CCS
    Health Information Management
    Barlow Respiratory Hospital
    2000 Stadium Way, Los Angeles CA 90026
    Tel: 213-250-4200 ext 3336
    FAX: 213-202-6490
    ssalinas@barlow2000.org

Sign In or Register to comment.