Outpatient Facility Coding Alert - 2014 Issue 9
Hospital Care: Report Hospital Visits Properly to Avoid Being A CERT Statistic
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Article Overview
This article provides a practical refresher for billing professionals and physicians who report hospital evaluation and management services. It focuses on common documentation and reporting issues in inpatient care, including admission status, observation versus inpatient distinctions, diagnosis coding, discharge documentation, and general compliance risks tied to CERT review findings. The content is aimed at helping readers recognize where hospital visit reporting can go wrong and what kinds of records and communication are needed to support accurate claims.
Why This Topic Matters
Hospital visit reporting errors can lead to denials, paybacks, underpayments, and compliance exposure. Understanding the documentation and reporting issues discussed here helps practices reduce risk and improve the accuracy of inpatient evaluation and management claims.
Article Sections
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Seven quick steps for reporting hospital visits
An overview of practical areas to review when reporting hospital care services. The section frames the article’s focus on inpatient billing accuracy and compliance risk.
What You Will Learn
- How hospital evaluation and management reporting can be affected by admission status and documentation
- Why supporting records from the hospital matter for inpatient visit reporting
- What kinds of hospital care reporting issues can create compliance or payment problems
- How discharge documentation and observation status can affect claims review
Who Should Read This
- Medical coders
- Billing staff
- Physician practices
- Compliance staff
- Hospital-based providers
Codes Discussed
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