Are you confused about how a physician determines that observation should be used rather than an inpatient admission? Or how condition code 44 should be used?
Join Duane C. Abbey, CFP, Ph.D in this 90-minute session that will discuss the confusion about whether a patient is an inpatient versus being an outpatient. When a patient is initially admitted as an inpatient, a determination may be made that the status should have been outpatient observation. Condition Code 44 was developed to address this type of situation, but there has been significant controversy concerning the use of Condition Code 44 and Part A to Part B billing. Also, there is a situation in which a hospital will, after the patient is discharged, determine that the inpatient admission was not appropriate. CMS has developed rules and regulations to address this situation and the general issue of Part B inpatient billing.
Duane will explain the Recovery Audit Contractors (RAC)s concerns about inpatient status, observation and possible recoupments, the difference between the ‘24-Hour’ Rule and the ‘Over 2-Midnights’ rule, and findings in cases such as the O’Connor Hospital Ruling. Discussions include Condition code 44, recent Federal Register discussions from CMS as well as the O’Connor Hospital appeal in this session. The program also includes the significant changes that CMS has made through the August 19, 2013, IPPS, Federal Register.
Objectives of the webinar:
Agenda of the webinar:
Who should attend? The session is appropriate for outpatient nursing staff, medical/surgical nursing staff, nurse managers, ED nursing staff, utilization review personnel, quality assurance personnel, quality assurance personnel, physicians, coding personnel, billing and claims transaction personnel, chargemaster coordinators, financial analysts, compliance personnel, and other interested personnel.
Duane C. Abbey, Ph.D. is a management consultant and president of Abbey & Abbey, Consultants, Inc., which specializes in healthcare consulting and related areas. Duane earned his graduate degrees at the University of Notre Dame and Iowa State University and has more than 20 years of experience as a consultant. He performs various types of financial analysis involving business structuring, organizational development, enrollment and other financially related concerns of organizations....
More Events By The Speaker