Are you leaving money on the table?


14 Sep Are you leaving money on the table?

By charting qualifying comorbidities in the Gaia EHR, you can increase your facility’s revenue over a 120-day period of $4,000.00 per 1 patient. Expand that to 5 patients over a year's time and add $20,000.00 to the bottom line just by documenting a GI Bleed.

What is a Comorbidity?

A comorbidity is a specific patient condition, secondary to the patient's principal diagnosis that necessitates dialysis, yet having a significant, direct effect on resource use during dialysis.


What categories are eligible for the adjustment?

The ESRD PPS provides adjustments for 2 chronic & 2 acute comorbidity categories.


The 2 chronic comorbidity categories eligible for a payment adjustment are:

  • Hereditary hemolytic or sickle cell anemia
  • Myelodysplastic syndromes


The 2 acute comorbidity categories that are eligible for the comorbidity adjustment are:

  • Gastrointestinal tract bleeding with hemorrhage
  • Pericarditis

What do you need to do?

For CMS to make a payment, you must report the diagnosis code on the claim.


CMS may make payment for the two acute comorbidity category adjustments for the month as long as the provider reports the diagnosis on the ESRD facility's claim and then for the next three months, regardless of whether or not the diagnosis code is on the claim after the first month.


With Gaia’s EHR, you and your staff can chart and follow the patient’s medical history while leveraging future adjusters through the Medicare payment system.


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