May, 2021
Throughout the COVID-19 pandemic, our clients have experienced an increase in the demand for ventilation services. Given the differences in levels of standard hospital reimbursement (see chart below), ensuring these cases are correctly coded can have a significant revenue impact.
Source: Using 2020 CMS Case Weights
The coding accuracy of ventilation cases has been on CBIZ’s radar for well over a decade. Even in non-pandemic times, hospitals too often coded these cases improperly. As these cases have become more frequent during the pandemic, we haven’t seen a corresponding improvement in coding accuracy.
As a response to the increase in ventilation cases, a number of our clients have asked us to provide a ventilator coding assessment, where we evaluate coding accuracy and appropriate reimbursement. In quite a few instances, our findings were significant; we found that our clients were under-coding ventilation cases more often than not, the effect of which resulted in assignment of a DRG resulting in lower reimbursement.
Are these issues occurring in your organization? Would your facility benefit from a ventilator coding assessment?
If interested, CBIZ would be happy to talk with you about our process. We look at cases from the last 12 months and focus on periods of high ventilation volume. We provide thorough reporting regarding coding accuracy and related reimbursement.
CBIZ’s Ventilator Coding Assessment is provided by our team of clinical reviewers who have focused on the intricacies of ventilator coding for many years. In addition to our reporting, our assessment also provides educational guidance and suggested action steps.
Ventilation services have played a critical role for hospitals since the beginning of the pandemic. We want to make sure that your organization is coding these cases correctly and receiving your entitled revenue. For more information about CBIZ’s Ventilator Coding Assessment, please contact the office at 800-957-6900 or email at kaconsults@cbiz.com.
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