RaeToll
Networker
I have an inpatient claim with TOB 0111, denied requesting a corrected claim with a code explaining the same date discharge. The patient was admitted inpatient status at 14:50 and discharged at 17:35.
Per CMS Manual Pub 100-04 Medicare Claims Processing, CPT codes 99234-99236 require a minimum of 8 hours inpatient stay. The manual directs me to use CPT codes 99221-99223 for same day discharge for less than 8 hours, however, when I ran these CPT codes through Revenue Cycle Pro, it indicated the CPT codes could only be used for TOB 013 (Hospital Outpatient) or 085 (Critical Access Hospital).
Can anyone direct me to what is the correct procedure for a same day discharge for less than 8 hours with a TOB 111?
https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/downloads/R1465CP.pdf
Per CMS Manual Pub 100-04 Medicare Claims Processing, CPT codes 99234-99236 require a minimum of 8 hours inpatient stay. The manual directs me to use CPT codes 99221-99223 for same day discharge for less than 8 hours, however, when I ran these CPT codes through Revenue Cycle Pro, it indicated the CPT codes could only be used for TOB 013 (Hospital Outpatient) or 085 (Critical Access Hospital).
Can anyone direct me to what is the correct procedure for a same day discharge for less than 8 hours with a TOB 111?
https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/downloads/R1465CP.pdf