Hospital Acquired Conditions (HAC)
Complicating conditions subject to Present-on-Admission screening for payment in Federal Fiscal Year (FFY) 2009.
The Deficit Reduction Act of 2005 mandated that the Centers for Medicare and Medicaid Services (CMS) identify at least two secondary diagnoses that are high cost and/or high volume, result in the patient's assignment to a higher-intensity DRG, and could reasonably have been prevented by the treatment facility. The conditions identified by CMS would not be recognized for payment for discharges occurring on or after October 1, 2008 (FFY 2009) if they were acquired during the patient's stay.
The final Inpatient PPS (IPPS) rule for FFY 2009, published in the August 19, 2008 Federal Register, identifies eleven (11) conditions that meet these mandated requirements and will not be recognized for Diagnostic Related Grouping when acquired in the hospital:
- Object Left in Surgery;
- Air Embolism:
- Blood Incompatibility:
- Catheter-Associated Urinary Tract Infection (UTIs);
- Stage III and IV Pressure Ulcers (Decubitus Ulcers);
- Vascular Catheter-Associated Infection;
- Mediastinitis After Coronary Artery Bypass Graft (CABG) Surgery;
- Falls and Trauma;
- Surgical Site Infections - Orthopedic, Total Knee, and Bariatric surgeries;
- Deep Vein Thrombosis/Pulmonary Embolism (DVT/PE);
- Glycemic Control (Diabetic Ketoacidosis/Nonketotic Hyperosmolar Coma).
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