tci Medicare Compliance & Reimbursement - 2014 Issue 12

Audits: Watch The Clock For Medicare Facility Observation Patients

Don’t include time a patient spends waiting for transportation after discharge. After the Centers for Medicare & Medicaid Services’ (CMS) implemented the controversial “Two-Midnight Rule,” the RACs have intensified scrutiny of hospital admissions. They will assume hospital admissions are reasonable and necessary for patients who stay in a hospital through two midnights. However, shorter stays are expected to be coded as outpatient observation.  Make Sure You Get Credit for Any Observation Time Prior To Admission The two-midnight rule requires that patients admitted to the hospital are expected to be hospitalized over two midnights. When this...

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