24-hour Rule
Designating Inpatient and Outpatient
Result of 24-hour rule hearing: Policy Committee
voted to remove the 24-hour rule. This change received approval.
Public Notice, SPA and other documentation are being worked on. This
change will be effective at the same time as the Outpatient conversion
go-live date. The programming will be end-date-of-service specific
Outpatient Resources:
Overview: Outpatient
presentation 5/19/2011
List of questions & answers from billers 2011-09-12
CMS Links
CMS Addendum: Click "accept" at the bottom, then save to your
computer. Be sure to view addendum B (List of Procedure codes & Medicare Reimbursement) &
addendum D1 (description of status indicators).
CMS Download web page. (CMS updates quarterly)
CMS Provider file:
Includes CCR value for hospitals (CMS updates quarterly)
Medicare outpatient manual "Chapter 4"
Medicaid
Coverage
Utah Hospital list: Indicating OPPS & CAH facilities
Revenue Code Traditional & Nontrad plan coverage: Medicare and
Medicaid
Medicaid Claim Flow Chart
Resolution Tracking
Lab Panel Payment Letter
Fee Schedules
2012
April 1, 2012
January 1, 2012
2011
December 1, 2011
November 1, 2011
October 1, 2011
September 1, 2011
What Edits
Will be Used?
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