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Acuity levels???

  1. Default Acuity levels???
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    Can anyone tell me if acuity level sheets are required to audit ED services? My boss says they are/were however the facility I am auditing says they don't use them. Are acuity levels optional or mandatory? I have never coded ED services before so this is all news to me. Help!

    Thank you!

  2. Default Facility or Physician
    Are you auditing physician or facility Levels? I think facility but just wanted to make sure before I venture a reply.


  3. Default
    It's for the facility.

  4. Default Required
    Mandatory might be too strong a word. But CMS is clear about using ED CPT Levels for facility side leveling. The issue I see is many hospitals use their own home grown guidlines for the Levels. I have even seen hospitals use only three Levels because originally there were only three APCs for the ED, But there are now 5 and CC. But I haven't seen any not coding ED Levels at all.
    Are you certain they are not coding any Levels for the ED facility side? Some hospitals will (wrongly) not code some Level 5s because they are bundled with the DRG on admission. But if this hospital is not coding Levels at all for the ED ( procedures only?), they are probably missing out on significant revenue.
    I have an article in next months Coding Edge about this issue. But I'd be happy to send you a copy,or discuss off line.


  5. Default Level Sheets
    I should thoroughly read questions! It looks like the hospital might code Levels but has no audit "sheets? That is possible. But CMS does require that hospitals have documented guidelines for Levels that would stand up to an audit.


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