CMS released eight frequently asked questions related to the Medicare Outpatient Observation Notice March 8, the date by which all hospitals and critical access hospitals were required to begin delivering the new patient notice.
If the attending physician writes an admission order and later decides that the case should have been outpatient and then writes and order for outpatient, do we still need utilization review involvement and condition code 44 to change to observation?
This week’s Medicare updates include additional guidance on the MOON form, an NCA for leadless pacemakers, delayed implementation of the (ESRD) Interim Final Rule – Third Party Payment, and more!
Obtaining appropriate inpatient status orders for inpatient-only procedures can be difficult due to the EMR and written orders that are still in existence. Is it true that if the surgeon or attending physician orders observation/outpatient status after an inpatient-only procedure that we must bill as outpatient? Can we use our utilization review committee to overturn the observation/outpatient order in this scenario? Please advise.
On Mondays, the facility where I work performs a self-audit on one- and two-day admissions that occurred over the weekend. We do this before the bill is dropped. If we find that an inpatient admission should have observation or outpatient, the billing department uses the appropriate codes for the claim and bills for Medicare Part B. Should we notify the patient of this change? Do we need to involve the physician who wrote the order?
The Medicare Outpatient Observation Notice is back and your organization should be ready to use it to comply with the NOTICE Act no later than March 8, roughly 90 days from the December 7 final approval of the form by CMS.
