Q&A: Timing of discharge for an inpatient-only procedure

Q: For an inpatient-only procedure, can the patient be discharged the same day?

A: All inpatient-only procedures must be performed on an inpatient basis, even if the patient is discharged the same day.

However, if the patient is discharged the same day, it is possible that the claim will be denied initially. The payer may question the timing because the inpatient stay was less than two midnights, even though that consideration is not relevant for inpatient-only procedures. You may need to appeal the initial denial and provide documentation demonstrating that the procedure is on the inpatient-only list and that the patient was safe to be discharged the same day.

Your MAC and auditors may scrutinize the procedure code to determine whether it is correct. They may question whether the procedure as documented actually an outpatient procedure and not one on the inpatient-only list.

For more information, see the April 26 webinar “Mastering the Inpatient-Only List: Strategies to Ensure Compliance and Avoid Denials.”