CMS’ inpatient-only rule seems simple enough on the surface—certain specified procedures, all noted in the OPPS inpatient-only list, must be performed on an inpatient basis regardless of the patient’s expected length of stay. But as with anything in healthcare, implementing this rule is hardly simple, and many organizations continue to misapply it and lose revenue as a result. Get expert answers to common inpatient-only compliance stumbling blocks.
Oversight of the practice of case management is a complex process. A number of moving parts must be factored in, including education, credentialing, and professional qualifications.
While there are many conferences that touch upon aspects of revenue integrity, RIS is the only one entirely dedicated to the topic. Plus, it is a great way to meet other professionals in the field of revenue integrity who are facing similar challenges and have similar interests.
Q: A diabetic patient is diagnosed with a gangrenous decubitus ulcer of the left heel and admitted to the hospital for treatment. If the provider documents an association between diabetes and the decubitus ulcer, which condition should be sequenced as the principal diagnosis?
