Health Information Management

Carefully review inpatient-only list according to year

APCs Insider, September 21, 2007

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QUESTION: Where can I find the inpatient-only list for surgery? We have recently opened an endoscopic suite and are remodeling our operating room. We have a general surgeon on staff and are ready to go. We are also a critical access hospital.

ANSWER: Go to the CMS Web site and look for the Hospital Outpatient Regulations and Notices page here.

Select the appropriate OPPS final rule for the year that you wish to view. Select Addendum B for the appropriate year and download the file. Sort the file by status indicator (SI) and then look for all of the codes with an SI of "C." C indicates an inpatient-only procedure. The inpatient only list changes each year, so you must select the appropriate final rule and Addendum B to have the correct inpatient-only list for that year.

Alternatively, you can select the appropriate OPPS final rule for the year that you wish, then select Addendum E and download the file. Addendum E contains nothing but the inpatient-only codes. Keep in mind that the inpatient-only list does not apply to critical access hospitals.



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