tci Outpatient Facility Coding Alert - 2012 Issue 3

CMS Creates New Indicator M5 for ASC Quality Measures Reporting

April 2, 2102 will mark full implementation of a new payment indicator that contractors must accept when ASCs report quality measures. Background: CMS stated in the CY 2011 OPPS Final Rule that a plan linking ASC payment to reporting quality data would be proposed in the following year. Subsequent work has led to the ASC Quality Collaborative recommending six measures to be used in implementing an ASC pay-for-reporting program. The recommendation has the National Qualify Forum's (NQF) endorsement and includes these measures: Patient falls in ASC Patient burn Hospital transfer or admission Wrong site, side, patient, procedure, implant Prophylactic IV...

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