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APPENDIX VIII: Medicare’s “No Pay for Errors” List*

  • Stage III and IV pressure ulcers

  • Fall or trauma resulting in serious injury

  • Vascular catheter-associated infection

  • Catheter-associated urinary tract infection

  • Foreign object retained after surgery

  • Certain surgical site infections (following coronary artery bypass graft, bariatric surgery for obesity, certain orthopedic procedures, implantation of cardiac electronic devices)

  • Iatrogenic pneumothorax with venous catheter placement

  • Air embolism

  • Blood incompatibility

  • Certain manifestations of poor blood sugar control

  • Certain deep vein thromboses or pulmonary embolisms (following certain orthopedic procedures such as total knee replacement and total hip replacement)

Source: Centers for Medicare & Medicaid Services.

*The policy works this way: if under the old payment system an item on this list would have increased the reimbursement for a given hospitalization under Medicare's system of diagnosis-related groups (DRGs), the hospital no longer receives that additional reimbursement under this policy. However, if there are any other so-called “complicating conditions,” the hospital still does receive the higher reimbursement, which mutes the financial impact of the policy. List is current as of August 2015.

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