Wiki CMS Inpatient Only Procedure List

[Cindi Bartman]

When completing a DRG validation with reference to a Surgical procedure. Acute Inpatient vs Observation/Outpatient level of status. When is it appropriate for a CPC and or CPC-H coder to determine that the surgical procedure is NOT a surgical code on the CMS IOP list and the claim should be denied at the Acute Inpatient Hospital Level of care.
Does the coder review the operative report and determine which code is most appropriate? and or take what the Surgical MD documented the procedure was actually stated?
Example: Total Complete Thyroidectomy;