Revenue Cycle

CMS clarifies how it will treat claims associated with denied inpatient stays

Recovery Auditor Report, July 23, 2009

According to a June 26 post on the CMS Web site:
CMS is often asked about other claim types that may be affected by a full inpatient denial and if the RACs will deny other claim types associated with the inpatient stay, such as physician evaluation and management services. At this time the RAC will not automatically deny claims that are associated with a full inpatient denial. However, these claims may be reviewed individually and there may be a need to fully/partially adjust the claim based on the documentation submitted.

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