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How Does Coding in Long-Term Acute Care Healthcare Facilities Work?

Posted By Giovanna Stahl
clinical coding solutions

Long-Term Care Hospitals are health care facilities that admit complex patients with acute care needs for a mean stay duration of 25 days. Many health care officials are perplexed when it comes to medical coding for Long-Term Acute Care Hospitals. Medical coding plays a crucial role in your patients' health and inaccurate coding can cause many challenges. 


At ECLAT Health Solutions, we provide accurate, efficient, and secure medical coding services. We outsource for hospitals, physician offices, Independent Practice Associations, and a variety of other healthcare providers. Since our coders are all highly trained and experienced, we guarantee a 95% or greater accuracy, so you can be assured your facility is receiving the best quality service.


Below, we discuss coding for Long-Term Acute Care Hospitals:

What Makes Long-Term Acute Care Hospital Coding Unique?

To recap, Long-Term Acute Care Hospitals (LTCH) are for clinically complex patients who have multiple acute or chronic conditions that require extended medical and rehabilitative treatments. Medicare certifies LTCHs as acute care hospitals as part of its condition of participation in the Medicare program. For a facility to qualify as an LTCH under Medicare, the average length of stay of a patient must be greater than 25 days. 


Unless the facility qualifies under section 1886(d) of the Social Security Act, then they must have an average stay of greater than 20 days. While the facilities have been certified by the Medicare acute care standards, the prospective payment system is based on the Medicare severity long-term care diagnostic related group system that acute care facilities use, with changes to relative weights to account for resource utilization specific to LTCHs.

Coding Guidelines

Since the Medicare severity long-term care diagnostic related group system is based on the inpatient prospective payment system (PPS), proper selection of principal and secondary diagnosis coding is imperative for accurate diagnostic related groups assignment. Coding professionals must work with their providers to ensure clear and concise documentation, as it is imperative for proper code selection. 

It is important to remember this as part of the new payment system includes a revision to the list of complications and comorbid  (CC) conditions. The complication and comorbidity list are mainly comprised of significant acute diseases, chronic diseases with acute exacerbation or those associated with debility, and end-stage diseases. Coding professionals should review the revised complication and comorbidity list to understand how it affects the diagnostic-related group system.

ECLAT Health Solutions: Professional Medical Coding Services 

It is vital to ensure your patients have the most efficient healthcare experience. At ECLAT Health Solutions, we provide high-quality outsourcing for medical coding services to ensure your patients' records are accurate. Our detail-oriented team uses a 3-Tier Quality Assurance process to identify and fix any coding and/or compliance errors to ensure it is accurate every time. We also offer a 24-hour turnaround time to give your facility the accurate coding it needs quickly and efficiently. 


Let our medical coding team assist you! Fill out our form to receive more information on our medical coding services.

Tags: International Coding, Medical Coding, long term acute care hospitals, medicare acute care standards