What is the CMS inpatient only list?

Since the beginning of the OPPS, CMS has maintained the Inpatient Only (IPO) list, which is a list of services that, due to their medical complexity, Medicare will only pay for when performed in the inpatient setting.

What is CMS addendum E?

Addendum E – This Text file lists CPT Codes That Would Be Paid Only As Inpatient Procedures as printed in Addendum E in the Federal Register. ( ZIP) Addendum H – Wage Index for Urban Areas (ZIP) Addendum N – This Excel file lists, in HCPCS order, the descriptor for Packaged Chemotherapy Drug Other than Infusion. ( ZIP)

What does inpatient only list mean?

“Inpatient-only” service is furnished, but the patient dies before inpatient admission or transfer to another hospital. The hospital reports the “inpatient only” service with modifier “CA” (Procedure payable only in the inpatient setting when performed emergently on an outpatient who expires prior to admission).

What is inpatient only procedures?

Inpatient only services are generally, but not always, surgical services that require inpatient care because of the nature of the procedure, the typical underlying physical condition of patients who require the service or the need for at least 24 hours of postoperative recovery time or monitoring before the patient can …

What is Addendum j?

Addendum J – Wage Index for Hospitals that are Reclassified (ZIP) Hospital-Specific Impacts – File layout (ZIP) Addendum D1 – This Excel file lists condition codes for the Hospital Outpatient Prospective Payment System (ZIP) Addendum I – Wage Index for Rural Areas (ZIP) Addendum H – Wage Index for Urban Areas (ZIP)

What is Addendum B?

Addendum B means the department’s document that lists Healthcare Common Procedural Coding System codes and describes payment information regarding outpatient hospital services; Sample 1.

What does Si mean on addendum B?

OPPS payment status indicators
Using Addendum B The OPPS payment status indicators (SI) can be found in Column C.

What procedures are on the inpatient list for 2022?

Only one code is being added to the IPO list for CY 2022: 0643T, Transcatheter left ventricular restoration device implantation including right and left heart catheterization and left ventriculography when performed, arterial approach.

Is Total shoulder replacement an inpatient only list?

For Medicare patients, CMS has removed total shoulder arthroplasty from the inpatient-only list, which allows same-day discharge from a hospital.