decisionhealth Newsletters, Coder Pink Sheets - 2010 Issue 10 (October)
‘Three-day window’ expansion hits hospital-owned practices
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Article Overview
This article covers a Medicare payment policy update affecting hospital-owned or hospital-operated practices, with emphasis on the expanded pre-admission bundling window and how CMS and a Medicare contractor describe related services. It is aimed at physicians, hospital-owned practices, coders, billers, compliance staff, and administrators who need to understand the scope of the policy change, the effective date, and the general kinds of services and ownership arrangements implicated.
Why This Topic Matters
The article matters because it highlights a Medicare change that can alter whether services furnished before an inpatient admission are paid separately or bundled into the hospital stay. Practices with hospital ownership or operational ties need to understand whether they fall within the policy scope and how CMS guidance may affect claims processing and compliance.
What You Will Learn
- How a Medicare pre-admission bundling policy was expanded
- Which types of hospital-owned practice arrangements are discussed
- What CMS and a Medicare contractor say about services tied to an inpatient admission
- How the article frames timing, implementation, and related billing considerations
Who Should Read This
- Physicians
- Hospital-owned physician practices
- Medical coders
- Medical billers
- Compliance staff
- Practice managers
- Hospital administrators
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