Health Information Management

Tip: CMS adds four inpatient-only procedures for 2014

APCs Insider, February 7, 2014

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For 2014, CMS did not remove any procedures from the inpatient-only list (status indicator C), but did add four procedures:
  • 44206, laparoscopy, surgical; colectomy, partial, with end colostomy and closure of distal segment (Hartmann type procedure)
  • 44207, laparoscopy, surgical; colectomy, partial, with anastomosis, with coloproctostomy (low pelvic anastomosis)
  • 44208, laparoscopy, surgical; colectomy, partial, with anastomosis, with coloproctostomy (low pelvic anastomosis) with colostomy
  • 44213, laparoscopy, surgical, mobilization (take-down) of splenic flexure performed in conjunction with partial colectomy
 
Medicare only provides payment for services on the inpatient-only list when the procedures are performed in the inpatient setting.
CMS’ 2-midnight benchmark for assuming medical necessity of inpatient status does not apply to the inpatient-only list as CMS recognizes patients receiving these procedures may stay less than two midnights.
 
This tip is adapted from “CMS adds cost centers, inpatient-only procedures for 2014” in the February issue of Briefings on APCs.



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