CMS issues guidance on hospital inpatient admissions
Hospitalist Leadership Connection, February 1, 2011
Medical necessity determinations are not only a hot button issue with recovery audit contractors, but also with the other “usual suspect” government auditors: Medicare administrative contractors, fiscal intermediaries, and comprehensive error rate testing contractors. So much, in fact, that CMS has released educational guidance to assist hospitals regarding inpatient admission decisions.
While many hospitals may in fact be utilizing proper screening criteria to analyze documentation and make medical necessity determinations, the fact remains that it's an imperfect endeavor. And while Interqual and Milliman, as well as other additional systems, may assist facilities in specific jurisdictions, CMS has issued a special edition MLN Matters article that points providers toward its own manuals for guidance. . . Read more on HealthLeadersMedia.com.
Related Products
-
Briefings on The Joint Commission
Briefings on The Joint Commission will help you with all of your accreditation and survey preparation needs. Every month...
-
The CMS Survey Coordinator's Handbook
There is no reason to struggle with CMS requirements. HCPro has teamed up with former contracted CMS surveyor Jeff Coleman...
-
The Surgical Hospitalist Program Management Guide:
The Surgical Hospitalist Program Management Guide: Tools and Strategies for Executives and Physicians is a first-of-its-kind...
-
CMS Hospital Conditions of Participation and Interpretive Guidelines
Navigating the CMS Web site to find accurate Medicare and Medicaid hospital regulations is a difficult and confusing task...
-
The CMS Joint Commission Crosswalk, 2012 Edition
Don’t settle for vague regulations when you can get a reliable Crosswalk that includes expert analysis and practical...
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
- Topic: CMS, OESS post new security compliance review information, checklist
- What does case-mix index mean to you?
- Capturing all necessary codes for IUD insertion and removal can be challenging
- News and briefs: Oklahoma Osteopathic Association against residency bill change
- QA:Coding multiple initial infusions
- OB services: Coding inside and outside of the package
- HIPAA Q&A: Level of encryption needed for email
- 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
- Catch up on what's new with injections and infusions
- New conflicts of interest create new challenges
- Q&A tackles coding questions about injections and infusions
- Joint Commission Center announces handoff communication solutions
- Inside best practice: Reduce patient falls with a stoplight
- Identify modifiable risk factors to prevent patient falls
- Hospitalist-surgeon comanagement has no effect on outcomes
- Case Management Monthly, June 2012
- Searched