Condition Code 44: Finding success in changes of level of care
Recovery Auditor Report, April 29, 2010
Managing condition code 44 is complex; and knowing that the RACs will be looking at a hospital’s use of condition code 44 make matters even more complicated. By establishing a method of review, the process can be simplified.
Condition code 44 applies when a hospital determines that specific services did not meet inpatient criteria, and is changed to outpatient. This essentially gives hospitals the option of recognizing an error and correcting it before a patient leaves the facility. Recognizing when to use condition code 44 however, can be tricky, and should begin with staff education, according to Jim Jones, Ph.D., RN, Administrative Director of Case Management / Patient Documentation at Bon Secours St. Francis Health System, Greenville, SC.
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