Health Information Management

Tip: Criteria for condition code 44

APCs Weekly Monitor, June 19, 2009

Want to receive articles like this one in your inbox? Subscribe to APCs Weekly Monitor!

Condition code 44, “inpatient admission changed to outpatient,” allows hospitals to change a patient’s status from inpatient to observation. This change can occur only  when a patient scenario meets the following four criteria:
  • The patient is still in the hospital
  • The facility has not  submitted the patient’s claim to Medicare
  • A physician (preferably the attending physician) agrees with the utilization review (UR) committee’s decision that outpatient care is more appropriate for the patient
  • A physician (preferably the attending physician) documents in the patient’s medical record his or her concurrence with the UR committee’s recommendation for a change in status
This tip was adapted from the article “The quick list: Condition code 44” in the June issue of Briefings on Coding Compliance Strategies.



Want to receive articles like this one in your inbox? Subscribe to APCs Weekly Monitor!

    Briefings on APCs

  • Briefings on APCs

    Worried about the complexities of the new rules under OPPS and APCs? Briefings on APCs helps you understand the new rules...

  • Medical Records Briefing

    Guiding Health Information Management professionals through the continuously changing field of medical records and toward a...

  • Briefings on Coding Compliance Strategies

    Submitting improper Medicare documentaion can lead to denial of fees, payback, fines, and increased diligence from payers...

  • Briefings on HIPAA

    How can you minimize the impact of HIPAA? Subscribe to Briefings on HIPAA, your health information management resource for...

  • APC Answer Letter

    Get this informative 8-page newsletter filled with answers to readers' questions!

Most Popular

Related Articles