Condition code 44 has been problematic for hospitals since its inception in 2004 due to CMS’ unclear language, multiple changes to the observation billing rules, and inconsistent guidance.
Care providers accept the general principle that patients have the right to direct their own care, but what if the patient refuses every discharge option you provide and wants to stay in inpatient care indefinitely?
As the case manager’s role has matured, specific best practices have proven to be a valuable conduit to the provision of care coordination, outcome achievement, and quality of care.
CMM asked hospital case management professionals what tasks their facilities expect them to perform and how those responsibilities affect their productivity in the CMM Job Responsibilities Survey. Nearly 500 case managers, discharge planners, social workers, clinical documentation improvement (CDI) specialists, and appeals specialists responded to the survey. Responses broke down as follows:
