terribo
Networker
i have a question regarding the new Medicare requirements for Inpatient versus Outpatient surgery codes which went into effect on 10/1/13.
I work for a Orthopaedic Specialty office. The new Medicare ruling defines a Inpatient POS admission as at least a 2 midnight admission. Per CMS, there are only specific surgical codes that meet the guidelines as being able to be performed as an IP. As a Orthopaedic practice, we see a lot of trauma patients that are admitted under another provider in another service, for example, the patient has a collapsed lung as well as other injuries that require the patient to be admitted under the other services care. Our office is only seeing the patient in regard to a distal radius wrist fracture in which a open reduction will be performed. The open reduction for the wrist surgical CPT code is not listed as a procedure that may be performed as a IP POS. Under normal circumstance, as in sheduled from the office for ORIF of the wrist, it would only apply as a outpatient surgical procedure. Because the patient is listed as IP with another service, wouldn't our POS for the wrist fracture also be listed as POS Inpatient. Or is our surgical procedure, because it's not on the accepted list of Inpatient only codes, be classified as POS Outpatient?
Sorry if this sounded like I am complicating matters, but I am a little confused. Thanks for any help any one may be able to provide me with.
I work for a Orthopaedic Specialty office. The new Medicare ruling defines a Inpatient POS admission as at least a 2 midnight admission. Per CMS, there are only specific surgical codes that meet the guidelines as being able to be performed as an IP. As a Orthopaedic practice, we see a lot of trauma patients that are admitted under another provider in another service, for example, the patient has a collapsed lung as well as other injuries that require the patient to be admitted under the other services care. Our office is only seeing the patient in regard to a distal radius wrist fracture in which a open reduction will be performed. The open reduction for the wrist surgical CPT code is not listed as a procedure that may be performed as a IP POS. Under normal circumstance, as in sheduled from the office for ORIF of the wrist, it would only apply as a outpatient surgical procedure. Because the patient is listed as IP with another service, wouldn't our POS for the wrist fracture also be listed as POS Inpatient. Or is our surgical procedure, because it's not on the accepted list of Inpatient only codes, be classified as POS Outpatient?
Sorry if this sounded like I am complicating matters, but I am a little confused. Thanks for any help any one may be able to provide me with.