• If this is your first visit, be sure to check out the FAQ & read the forum rules. To view all forums, post or create a new thread, you must be an AAPC Member. If you are a member and have already registered for member area and forum access, you can log in by clicking here. If you've forgotten the password it can be reset on our sign in section by entering your registered Email Address or Username here. To start viewing messages, select the forum that you want to visit from the selection below..

Wiki Two- Midnight Rule

Create Wiki
Jennifer Turner

Jennifer Turner

Guest
Messages
38
Location
Indianapolis, IN
Best answers
0
Hello Fellow Coders!

I am needing any input on this one. Does this rule apply only to pt.'s who have traditional Medicare as the primary payor? I have exhausted all resources at this point & All of the information that I have researched shows strong evidence that this rule only applies to traditional Medicare pt.'s....... Between 3 coders within our practice there is really no clarity, a lot of back and forth.

Any help is very much appreciated. Thank you so much!!
 
The two-midnight only applies to traditional Medicare beneficiaries (A/B patients), although Medicare Advantage programs (Part C) may choose to follow this rule, usually based upon a contract with the hospital. This is the biggest reason that the two-midnight rule has not simplified things for hospitals or physicians since each payer may or may not follow this guidance.
 
You must log in or register to reply here.
Top