tci Part B Insider - 2014 Issue 19

Physician Notes: 'Two Midnight' Rule Needs Revision, OIG Says

Plus: Billing extra codes for urine testing cost this lab over $4.6 million. It hasn’t even been a year since CMS enacted its “Two Midnight” rule, but the OIG is already questioning the decision.  Background: Last October, Medicare ruled that surgical procedures, diagnostic tests and other treatments are “generally appropriate for inpatient hospital admission and payment under Medicare Part A when (1) the physician expects the beneficiary to require a stay that crosses at least two midnights and (2) admits the beneficiary to the hospital based upon that expectation.” In testimony to Congress...

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