CMS is reexamining inpatient criteria because it has seen a significant increase in the number of patients spending more than 24 hours in observation. Providers are worried that a Recovery Auditor will deny a short inpatient stay for lack of medical necessity and recoup payment years later. So instead, some facilities place patients in observation for longer time periods.
The AMA revamped coding for molecular pathology beginning in 2012 and continuing in the 2013 CPT ® Manual. Now CMS is trying to determine how to pay for those tests and the agency wants to hear from providers.
If many acute care hospitals struggle to protect patient privacy, long-term care organizations face their own challenges in ensuring the privacy of residents who live in their nursing homes and assisted living facilities.
