Summary

Description

A new study, Examination of the Accuracy of Coding Hospital-Acquired Pressure Ulcer Stages, published in Volume 4, Issue 1 of the Medicare and Medicaid Research Review, examines the observed underreporting of pressure ulcer Hospital-Acquired Condition (HAC) stages. The authors analyses of Medicare claims data from 2009 and 2010 show that 54 percent of claims with a secondary diagnosis code of a pressure ulcer site did not have any pressure ulcer stage code (compared to only 10 percent of claims with a pressure ulcer as a primary diagnosis). On average, underreporting of stage codes occurred more often in hospitals classified as academic medical centers, larger, urban, or not-for-profit. The combination of capturing 25 diagnosis codes under the new 5010 claim format and the change from ICD-9 to ICD-10 will likely reduce some of the underreporting of the stages for hospital-acquired pressure ulcers.