Suspension Criteria Change Effective 6/18/2018

Posted on May 2, 2018 in Health Information Management | 0 comments

Suspension Criteria Change Effective 7/13/2018:

  • Summit MEC approved change 3/13/2018 in suspension criteria to include the following elements currently listed under “Review Deficiencies”:

Missing or incorrect Discharge / Admission Dates

Missing EBL, SPECIMEN

Missing Discharge Diagnosis

Missing Dispositions

Missing pre/post OP diagnosis

  • Please ensure you are completing these deficiencies within 14 days of receiving as they will now be included in suspension processing.
  • Coding queries are NOT included.
  • Please work with Patty Fitzgibbons, Summit Physician Liaison if you need assistance modifying your templates to include all required information.

Content requirements for Immediate Post-Operative note and Operative/Procedure Notes:

  • Is EBL and Specimen Removed required in ALL l Immediate Post Op notes and Operative/Procedure Notes, regardless of type of operative procedure
  • YES, per Sutter Licensing and Accreditation, the Estimated Blood Loss and Specimen removed should be included in both the Immediate Post Op progress note template and the Operative /Procedure Report template regardless of operation or procedure type.
  • If there is no blood during procedure, document “ no blood loss” or NA
  • If there is no Specimen Removed, document “none”
  • Please reach out to Patty Fitzgibbons- Summit Physician Liaison if you need assistance adding these requirement to your documentation templates.

History and Physical Information:

  • You may be asked for H&P if the analyst cannot find one attached to the correct surgical encounter. To avoid this please ensure the following:
  • If you are completing your H&P in the office, please ensure you are documenting the H&P on the correct surgical encounter. You may also copy and paste your office H&P into the correct surgical encounter.  If you are using an office H&P or copy and paste functionality, please ensure your H&P dates are within 30 days of the patient admission.   H&P outside of this 30 day time period do not meet regulatory standards.

Leave a Reply

Your email address will not be published. Required fields are marked *