Hello, I am new to in-patient facility coding and would like some insight on understanding why our facility is not getting outlier payments above the DRG amount. I have studied the multitude of information on this but still am not clear.
Example: If covered charges exceed the outlier threshold amount, and there is a value code of 80 with 4 days in form locator 40. the patient stay was 4 days. Should the hospital expect outlier reimbursement? Any insight would be very much appreciated!
Example: If covered charges exceed the outlier threshold amount, and there is a value code of 80 with 4 days in form locator 40. the patient stay was 4 days. Should the hospital expect outlier reimbursement? Any insight would be very much appreciated!