All Entries Tagged With: "utilization review"
Compliance with Condition Code 44 – A practical approach
This week, let’s continue our focus on the so-called Condition Code 44 process. If followed carefully, this process would permit hospitals to convert what would otherwise be non-covered inpatient services under Part A to outpatient services under Part B. Once converted, presumably, these services would then be subject to the same terms and conditions of coverage as if they actually had been provided in the outpatient setting. [more]
Condition Code 44 – Let’s focus on process
Last week, Kimberly Hoy brought up some additional questions about the conversion of inpatient hours to observation time, following a Condition Code 44 change of inpatient status to outpatient care. That article prompted several additional questions from readers, including questions about the process that hospitals need to follow in order to assure that they receive essentially the same reimbursement for those inpatient services as they would have received if the services actually had been provided in the outpatient setting. [more]
