Health Information Management

Q/A: Length of recovery time

APCs Insider, August 13, 2010

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Q: Compliance staff at the central billing office of our OPPS hospital have indicated a potential compliance risk if we charge for hours of extended recovery (with revenue code 710) beyond the typical six-hour recovery period when patients don’t qualify for observation or inpatient level of care status. Others say that including charges for this service time is appropriate as a means of providing cost data to CMS if we provide this care based on physician order and the standard of care within our community. Please comment. 

A: It is very appropriate for a hospital to report charges representing its cost of caring for patients and delivering services.

There is no magic four to six hours of recovery. The likely recovery period is different for each procedure/patient circumstance. Typically, recovery in a postsurgical acute care unit (PACU) is charged in increments of 15 minutes. A short-stay recovery area may be charged in increments of 30 or 60 minutes. Then the patient is transferred to a nursing unit in a bed to receive additional postsurgical recovery. Nursing units may have private or semi-private rooms in which a medical observation patient, who is charged hourly charges for observation services, occupies the next bed. The room is used by the post surgical patient to whom nursing, housekeeping, dietary, and other services representing costs are delivered. It is totally appropriate to charge hourly recovery charges at the same price as hourly observation services for the care the patient receives.

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