2010 IPPS Final Rule Provides Payment Update

The 2010 Inpatient Prospective Payment System (IPPS) Final Rule, released July 31, provides acute care hospitals with an inflation update of 2.1 percent in their 2010 payment rates. The documentation and coding adjustment the Centers for Medicare & Medicaid Services (CMS) proposed in May has been put on hold.

CMS said in a press release that a document and coding adjustment will not be implemented for 2010; but the agency will consider phasing in future adjustments over an extended period, beginning in fiscal 2011, based on a complete analysis of  fiscal 2008 and 2009 data.

Teaching hospitals will continue to receive the full capital indirect medical education (IME) adjustment in 2010.

The final rule adds four new measures for which hospitals must submit data under the Reporting Hospital Quality Data for Annual Payment Update (RHQDAPU) program to receive the full market basket update.

The two additions to the existing Surgical Care Improvement Project (SCIP) measure set are:

  • SCIP Infection (INF) 9 – Urinary catheter removed on postoperative day one (POD1) or postoperative day two (POD2)
  • SCIP INF 10 – Surgery patients with perioperative temperature management

The two structural measures are:

  • Participation in a systematic clinical database registry: Nursing sensitive care
  • Participation in a systematic clinical database registry: Stroke care

Hospitals not participating in the quality reporting program will receive the update less two percentage points.

A link to the complete list of complications/comorbidities (CC) and major complications/comorbidities (MCC) additions and deletions (Tables 6G-6K) can be found on the FY 2010 Final Rule Home Page on the CMS Web site.

A link to new, revised, and invalid diagnosis and procedure codes can be found on the New, Deleted, and Revised ICD-9-CM Codes – Summary Tables page on the CMS Web site.

Changes will be effective beginning with discharges on or after Oct. 1.

The 2010 IPPS Final Rule was placed on display at the Federal Register July 31, and can be found under Special Filings. It will appear in the Aug. 27 Federal Register.


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