Wiki Where do you find Medicare's Allowed Outpatient Procedure List?

[KRISTILEFT]

I hope I'm not the only one who gets frustrated trying to find anything on Medicare's/CMS's (Florida) website! I am trying to find a list of procedures allowed in an outpatient setting. My doc's are doing more and more outpatient, which is a benefit to the patient, lowering their out-of-pocket expense. However, we need to make sure we are not shooting ourselves in the foot if the rules say a particular procedure should be done inpatient. I have a denial right now from Blue Cross that I need to appeal but need some resources to back it up. If anyone has the link to Medicare's list I would be forever in your debt!!

 

[RebeccaWoodward*]

Do you have this link already? This is the list for inpatient procedures only.

http://www.cms.hhs.gov/hospitaloutpatientpps/hord/ItemDetail.asp?ItemID=CMS1204971

Addendum E

This would eliminate the question if it requires inpatient.

 

[KRISTILEFT]

Rebecca,
Thank you so much for answering me However, I clicked on the link you sent and it says that the list is not currently available. Of course! Just my luck Thanks again!

 

[RebeccaWoodward*]

Kristi,

Try again...I just opened it up.

When you open up the link, click on addendum E. Addendum E will then prompt you to select the privacy agreement...select Yes. This will prompt you to an excel speadsheet.

 

[KRISTILEFT]

Rebecca....you're a peach!! You are Queen of the Day! I don't know what I did the first time but it worked this time....THANK YOU!!