The Proper Use of
Condition Code 44 – Converting IP to OP
with a *NEW* Decision Tree
We’ve recently heard reports that there are many hospitals using Condition Code 44 on an increasing basis — which is not supposed to be the case. According to CMS, CC 44 is a way of identifying and/or preventing billing issues when an admission is deemed to be inappropriate, and the provider wishes to correct their error, before billing. It was imagined to be a “rare” event. So why are there so many questions about it, and why is it showing up with increasing frequency?
So we created this Decision Tree to help you keep everything straight. During the show we review the logic and discuss some “wrinkles.”
Remember: our Decision Trees are published under a copyright that lets you copy and distribute them, as long as you leave them as is.
There were some billing questions this week, and we went over those with our Revenue Cycle expert, Sharon Easterling, CEO at Recovery Analytics. We also went thru a couple of scenarios from Dr. Deepak Pahuja, CEO & CMO at Aerolib Healthcare Solutions.
Our new Decision Tree on Condition Code 44
MedLearn Matters Number SE0622CMS Transmittal 299
Noridian IPPS Q&A
Federal Register §482.30 (2011 COP)
List of links to the original documents
Dr. Pahuja’s Slides – A Primer on CC44
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