Under the inpatient prospective payment system (IPPS), there is a 3-day payment window
(formerly referred to as the 72-hour rule). This rule requires that outpatient preadmission services
that are provided by a hospital up to three calendar days prior to a patient's inpatient admission
be covered by the IPPS MS-DRG payment for
A. diagnostic services.
B. therapeutic (or nondiagnostic) services whereby the inpatient principal diagnosis code
(ICD-10-CM) exactly matches the code used for preadmission services.
C. therapeutic (or nondiagnostic) services whereby the inpatient principal diagnosis code
(ICD-10-CM) does not match the code used for preadmission services.
D. diganostic services and therapeutic (or nondiagnostic) services whereby the inpatient
principal diagnosis code (ICD-10-CM) exactly matches the code used for preadmission
services.
Question 2
Observation services furnished in a hospital outpatient setting where the patient is considered an outpatient __________.
a. are reimbursed when ordered by a physician
b. include a bed but no monitoring procedures
c. must be preauthorized by Medicare
d. routinely convert to an inpatient admission
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