Unraveling the costly inpatient-only procedures puzzle
Briefings on APCs, August 1, 2008
This is an excerpt from a member only article. To read the article in its entirety, please login or subscribe to Briefings on APCs.
Few CMS rules are as confusing as those for inpatient-only procedures performed in outpatient settings. Although CMS appears interested in learning when such procedures are justified, many believe the current process penalizes facilities that pass along the information.
The basic rule for billing inpatient-only claims, reiterated in quarterly OCE updates, is as follows: If a physician performs a procedure on the inpatient-only list (OCE Addendum B) on an outpatient basis, and the procedure appears on a claim, the OCE denies the entire claim and returns it to the provider.
This is an excerpt from a member only article. To read the article in its entirety, please login or subscribe to Briefings on APCs.
Comments
0 comments on “Unraveling the costly inpatient-only procedures puzzle ”
Related Products
Most Popular
- Articles
-
- Q/A: Volume requirement for reporting hydration services
- Featured blog post: Nurses face felony charges after reporting physician to the Texas Medical Board
- Catch up on what's new with injections and infusions
- Identify potential Medicaid RAC target areas
- Topic: CMS, OESS post new security compliance review information, checklist
- HIPAA Q&A: Level of encryption needed for email
- Capturing all necessary codes for IUD insertion and removal can be challenging
- What does case-mix index mean to you?
- OB services: Coding inside and outside of the package
- QA:Coding multiple initial infusions
- E-mailed
-
- Q/A: Volume requirement for reporting hydration services
- Featured blog post: Nurses face felony charges after reporting physician to the Texas Medical Board
- HIPAA Q&A: Level of encryption needed for email
- Q&A: Follow CMS' coding guidelines when using modifier -25
- What does case-mix index mean to you?
- Catch up on what's new with injections and infusions
- CMS has reformulated payments for some bilateral procedures
- New conflicts of interest create new challenges
- Q/A. One injection code or two?
- ED-to-inpatient transfers are flawed with safety gaps
- Searched