Q&A: Inpatient Certification

April 19, 2016
Medicare Web

Q: What elements must be included for inpatient certification?

A: The inpatient certification may be made with a specific separate certification form or constructively through the forms, notes, or records signed by the certifying physician. There are three elements to the certification:

  1. The reason for continued hospitalization of the patient or the special or unusual services for cost outlier cases
  2. The estimated time the patient will need to remain in the hospital
  3. Plans for postdischarge care, if appropriate

For more information, see the Patient Status Training Toolkit for Utilization Review.

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