Health Information Management

I/OCE quarterly update: CMS addresses condition code 44, billing for radiopharmaceuticals and nuclear medicine

APCs Insider, October 30, 2009

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As part of Medicare Claims Processing Manual (MCPM) Transmittal 1803—the October 2009 update to OPPS—CMS supplies additional information about condition code 44 and instructions for billing radiopharmaceuticals and nuclear medicine. The changes became effective October 1.
 
Hospitals use condition code 44 when they change a patient’s initial status from inpatient to outpatient for purposes of billing and payment. This generally occurs when utilization review (UR) personnel determine that the patient does not meet Medicare’s inpatient guidelines.
 
Continue reading “I/OCE quarterly update: CMS addresses condition code 44, billing for radiopharmaceuticals and nuclear medicine” on the HCPro Web site. Briefings on APCs subscribers have free access to this article in the November issue.



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