Facility Coding: You Don't Need To Stay Up Late To Understand The Two Midnight Rule

Why This Topic Matters

Correctly understanding hospital status policy affects patient billing, facility reimbursement, audit exposure, and whether a patient may later qualify for post-acute care coverage. The article helps readers assess how CMS guidance can influence ED workflow and inpatient-versus-outpatient classification.

Article Sections

1. The RAC Is Watching, But Not Acting For Now

   Introduces the Medicare hospital-stay benchmark and the related audit environment. Summarizes the temporary enforcement timing described in the article.

2. There Is An Exception Clause

   Describes how mixed hospital encounters are addressed when outpatient time precedes an inpatient order. Covers the broader context for counting hospital time and the role of contractor review.

3. Follow These Tips To Stay Out Of Trouble

   Discusses operational effects on hospital throughput and observation management. Frames the policy’s impact on emergency department workflow and facility efficiency.

4. No Change to Skilled Nursing Facility (SNF) Requirements

   Explains the relationship between inpatient hospital time and later skilled nursing facility eligibility. Addresses how the policy affects the timing of the qualifying hospital stay.