Critical Access Hospitals and the 3-Day Window Rule

One of our listeners — Joni — last week on Monitor Monday called to our attention to the fact that CGI had inappropriately denied ED charges within the 3-day window of an inpatient admission to Critical Access Hospitals. Critical Access hospitals are not subject to the 3-day window rule.

CGI has now reversed their findings. The issue number is B001742010-Outpatient claims billed within a PPS inpatient admission.