Special Project - Gastrointestinal Disorders

In July 2006, the Centers for Medicare & Medicaid Services (CMS) approved IPRO's launch of a new HPMP project to reduce payment errors in Medicare claims data in New York State hospitals. The purpose of the project is to assist hospitals in reducing both inappropriate admissions and occurrences of incorrect coding/DRG assignment for DRG 174 (GI Hemorrhage with CC) and DRG 182 (Esophagitis, Gastroenteritis and Miscellaneous Digestive Disorders age > 17 with CC ).

IPRO will select both a baseline and a re-measurement sample of cases to be evaluated for admission necessity and coding/DRG assignment accuracy from 20 New York State short-term acute care hospitals. More details are available in the HPMP Special Project - Reduction of Payment Errors for DRGs 174 and 182 Administrative Memo.

Resources

IPRO's Aggregate Baseline Report
Recorded Trainings:
Coding Booklet:
Data Reports:

Dissemination of hospital-specific data reports on billing patterns for DRGs related to gastrointestinal disorders (i.e., DRGs 174, 175, 182, 183) began in August 2006. These reports are based on administrative claims data and are available quarterly throughout the project.

HPMP Insight (IPRO's electronic newsbrief covering HPMP issues):
Administrative Memos
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