AMA CPT® Assistant - 2000 Issue 5 (May)

Medicare Reporting-Outpatient vs. Inpatient? (May 2000)

May 2000 page 10 Coding Commentary Medicare Reporting-Outpatient vs. Inpatient? The Hospital Outpatient Prospective Payment System (OPPS) includes payment status indicators that indicate procedures that have been determined to require inpatient care because of the invasive nature of the procedure, the need for postoperative care, or the underlying physical condition of the patient who would require the surgery. Therefore, since certain surgically invasive procedures, such as craniotomies, coronary artery bypass grafting, and laparotomies, indisputably require inpatient care, certain CPT codes relating to these procedures are outside the scope of outpatient services, and not subject to payment under the OPPS...

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