Health Information Management

Inpatient to outpatient: Understand requirements of condition code 44

Briefings on APCs, April 1, 2010

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Requirements of condition code 44

Condition code 44 changes a patient’s initial inpatient status to outpatient for purposes of billing and payment. It may be necessary to use condition code 44 when case management and other UR personnel are not available (e.g., weekends and holidays) at the time that a physician decides to admit a patient and the UR committee later determines that the patient does not meet Medicare’s inpatient criteria. 

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