Health Information Management

CMS reverses policy on inpatient-only procedures

APCs Insider, March 20, 2015

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By Steven Andrews
This week, CMS released Transmittal 3217, effective April 1, which will allow inpatient-only procedures to be included on inpatient claims similar to other outpatient services included in the three-day window.
This reversal of former policy allows an inpatient-only procedure provided on an outpatient basis to be covered if the patient is subsequently admitted. It provides relief for a long-standing issue for hospitals and that has more recently been aggravated by confusion created by the 2-midnight policy.
The change still leaves providers with questions, such as whether services covered by the OPPS performed in an outpatient setting on the same day as a preadmission inpatient-only procedure should be reported on the subsequent inpatient claim.
For more details, see this article in Medicare Insider from HCPro Boot Camp instructor Judith Kares, JD.

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