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Infection Control 46 How ASCs Can Effectively Handle CMS Quality Reporting: Q&A With Allison Errickson of ProVation By Laura Miller A coding for a patient encounter. So ASCs need to ensure the coders/billers receive a copy of the nursing documentation to ensure the appropriate Gcodes are included on the bill. These G-codes need to be included on the bill for Medicare patients even if none of the events occurred. llison Errickson, CPC-H, director of coding compliance for ProVation Medical, part of Wolters Kluwer Health, discusses the biggest challenges for ambulatory surgery centers with quality reporting for The Centers for Medicare and Medicaid Services and what to watch for in the future. Sites really need to have a designated person monitoring this program to ensure they are staying ahead of the game. The five measures I mentioned are just the first wave of this program. Starting in 2013, there will be two new measures sites will have to report; safe surgery checklist use in 2012 and volume of certain procedures in 2012. Q: What are the biggest challenges ASCs face with the new Medicare quality reporting system? Allison Errickson: I think one of the biggest challenges is the overall process change, not only for the nurses in terms of their documentation, but also for the coders and billers. The 2013 measures are a great example of why it's so important to have a designated person monitoring this program. Even though these two measures don't have to be reported until 2013, the data that sites will report on is from 2012. They will have to report if they used a safe surgery checklist in 2012 and the procedure volume will be based on 2012 numbers. Sites that haven't been tracking this information in 2012 may have trouble when it comes time to report this in 2013. If sites are unable to report on this information, they'll face financial penalties down the road. The quality reporting program requires ASCs to report five quality measures by submitting G-codes on the CMS-1500 claim form for Medicare patients. Documentation of the measures, which include patient burn, patient fall, wrong site/wrong side/wrong patient/wrong procedure/wrong implant, hospital admission/transfer, and prophylactic IV antibiotic timing, will most likely be found in the nursing documentation. Coders/billers are not in the habit of waiting for nursing documentation to complete the How Healthy Is Your Bottom Line? Physicians' Capital Investments (PCI) is owned in part by physicians who understand your needs and the challenges you face on a daily basis. Let PCI help you plan for your future by financing and developing your new medical facility, or enhance your liquidity position by monetizing your existing medical facility. Our proven model turns exceptional physicians into extraordinary business people. l Real E So lut ions • te Me d i ca s ta Custom financing options Unique whole and fractional ownership models Distinctive medical development solutions Robust investment management services National medical development footprint • • • • • • 866.936.3089 Consulting@physcap.com www.physcap.com 8117 Preston Road, Suite 400 Dallas, TX 75225 © Copyright 2013 Physicians' Capital Investments. All rights reserved. Publication: Becker's ASC Review — January/February, 2013