Significant changes are coming to the inpatient-only list for 2021. The financial implications to surgery status can be staggering. Master correct surgery status during this exclusive RACmonitor webcast.
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The Medicare inpatient-only list, long a guidepost in helping determine the proper admission status for patients undergoing surgery, today is a source of confusion, especially since The Centers for Medicare & Medicaid Services (CMS) began removing certain surgeries from that list. Case in point: total joint arthroplasty (TJA).
CMS sent waves of trepidation through the industry when the agency released the 2021 Outpatient Prospective Payment System (OPPS) proposed rule, removing hundreds of procedures and indicating they plan to eliminate the inpatient-only list in totality over the next few years.
Providers are rightly concerned with the OPPS proposed rule and have many questions about how to handle surgery status determinations. Because of this significant level of confusion, RACmonitor commissioned Dr. Ronald Hirsch to lead this timely and important webcast.
During this RACmonitor webcast, Dr. Hirsch will review and translate the regulations from CMS. And then, he will explain what procedures are being removed from the list for 2021, how CMS is choosing them, and how every facility should choose what status to use for their patients based on the guidance from CMS.
There is a significant amount of confusion and misinformation surrounding the inpatient-only list, especially since the 2021 Outpatient Prospective Payment System (OPPS) proposed rule signals an intent to eliminate the list over the next coming years.
Those who will benefit most from this webcast include staff in utilization review, revenue cycle, revenue integrity, case management and compliance, as well as chief financial officers, physicians and physician advisors, and billing and coding professionals.
Ronald Hirsch, MD, FACP, CHCQM-PHYADV, CHRI, FABQAURP is vice president of the Regulations and Education Group at R1 Physician Advisory Services. Dr. Hirsch’s career in medicine includes many clinical leadership roles at healthcare organizations ranging from acute-care hospitals and home health agencies to long-term care facilities and group medical practices. In addition to serving as a medical director of case management and medical necessity reviewer throughout his career, Dr. Hirsch has delivered numerous peer lectures on case management best practices and is a published author on the topic. He is a member of the Advisory Board of the American College of Physician Advisors, a member of the American Case Management Association, and a Fellow of the American College of Physicians. Dr. Hirsch is a member of the RACmonitor editorial board and is regular panelist on Monitor Mondays.
The opinions expressed are those of the author and do not necessarily reflect the views, policies, or opinions of R1 RCM, Inc. or R1 Physician Advisory Services (R1 PAS).
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