Corporate Compliance

Know the rule for billing inpatient-only procedures

Health Care Auditing Strategies, February 1, 2009

Although the rule for inpatient-only procedures in an outpatient setting may initially seem rather basic, there are exceptions that make the rule a bit more complex. In simple terms, the rule for billing inpatient-only procedures states that CMS will not pay for procedures designated as inpatient-only when providers perform them in an outpatient setting.

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