title: Justifying short inpatient stays just got easier--or did it?
abstract: In the Outpatient Prospective Payment System final rule for 2016, the Centers for Medicare & Medicaid Services modified the two-midnight rule to allow shorter stays to be billed as inpatient stays based on the judgment of the admitting physician. CMS shifted enforcement of the rule to two Beneficiary and Family-Centered Care Quality Improvement Organizations, which will alert the Recovery Auditors if they find patterns of high rates of claims denials. CMS did not include any guidance about what constitutes a short stay except to say that it's a matter of physician judgment. Case managers should review every patient's records to ensure that the physician documentation supports an inpatient admission and that the admitting order is signed by the admitting physician before the patient is discharged.
mesh_terms: D014487:Centers for Medicare and Medicaid Services, U.S.; D006801:Humans; D007297:Inpatients; D007600:Judgment; D007902:Length of Stay; D008505:Medical Staff, Hospital / Q000523:psychology; D014481:United States