tci E/M Coding Alert - 2014 Issue 4

Inpatient Coding: Be Aware of the New Inpatient Definition or Face Denials

Expect exceptions when using the “two-midnight” rule.  In the updated 2014 Inpatient Prospective Payment System (IPPS), the Centers for Medicare & Medicaid Services (CMS) redefined as how inpatient and outpatient are used in a facility setting. If you don’t know the ins and outs of the new, so called “two-midnight” rule, you take the risk that Medicare Part A won’t cover the hospital stay. Here’s what you need to know to keep your claims in the right category.  Educate Yourself on the CMS Definitions  Under the new “two-midnight rule,” an...

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