Book contents
- Observation Medicine
- Observation Medicine
- Copyright page
- Contents
- Advance Praise
- About the Editors
- Contributors
- Foreword: Onward and Upward
- Preface
- Part I Administration: Key Concepts of Observation Medicine, and Developing and Maintaining an Observation Unit
- Part II Observation Medicine: Clinical Setting and Education
- Part III New Developments in Observation Medicine
- Part IV Clinical
- Part V Financial
- Subpart VA Financial – Coding and Reimbursement
- Subpart VB Financial – Case Management
- Subpart VC Financial – Medical Necessity, Denials and Appeals
- Subpart VD Financial – The Business of Observation Medicine
- Part VI International
- Part VII Evidence Basis for Observation Medicine
- Part VIII Clinical Protocols
- Part IX Administrative Policies
- Part X Order Sets
- Prologue
- Index
- References
Subpart VB - Financial – Case Management
from Part V - Financial
Published online by Cambridge University Press: 31 March 2017
Edited by
Book contents
- Observation Medicine
- Observation Medicine
- Copyright page
- Contents
- Advance Praise
- About the Editors
- Contributors
- Foreword: Onward and Upward
- Preface
- Part I Administration: Key Concepts of Observation Medicine, and Developing and Maintaining an Observation Unit
- Part II Observation Medicine: Clinical Setting and Education
- Part III New Developments in Observation Medicine
- Part IV Clinical
- Part V Financial
- Subpart VA Financial – Coding and Reimbursement
- Subpart VB Financial – Case Management
- Subpart VC Financial – Medical Necessity, Denials and Appeals
- Subpart VD Financial – The Business of Observation Medicine
- Part VI International
- Part VII Evidence Basis for Observation Medicine
- Part VIII Clinical Protocols
- Part IX Administrative Policies
- Part X Order Sets
- Prologue
- Index
- References
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- Observation MedicinePrinciples and Protocols, pp. 363 - 369Publisher: Cambridge University PressPrint publication year: 2017
References
References
Centers for Medicaid and Medicare Services (CMS) https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/downloads/R1374CP.pdf (Accessed April 2016)Google Scholar
Hospital Inpatient Admission Order and Certification https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/Downloads/IP-Certification-and-Order-09-05-13.pdf (Accessed April 2016)Google Scholar
Final Comments for Acute Inpatient Services versus Observation (Outpatient) Services (Hosp-001) DL322. https://downloads.cms.gov/medicare-coverage-database/lcd_attachments/32222_1/DL32222_HOSP001_FinalComments.pdfA (Accessed April 2016)Google Scholar
Clarification of Medicare Payment Policy When Inpatient Admission is Determined Not to be Medically Necessary, Including the Use of Condition Code 44: “Inpatient Admission Changed to Outpatient”Transmittal #: R299CP https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNMattersArticles/downloads/SE0622.pdf (Accessed April 2016)Google Scholar
References
Medicare Benefit Policy Manual, CMS Pub. 100-02, Chapter 6, §20.6.Google Scholar
DHHS. National Strategy for Quality Improvement in Health Care. www.healthcare.gov/center/reports/nationalqualitystrategy032011.pdf March 2011.Google Scholar
Ibid.Google Scholar
O’Reilly, K. Health Reform Law Will Boost Care Quality. Amednews.com. www.ama-assn.org/amednews/2010/12/20/prse1221.htm. June 2012.Google Scholar
Case Management Society of America Standards of Practice for Case Management, Revised 2010. www.cmsa.org/SOP. June 2012.Google Scholar
National Quality Forum (NQF) - Endorsed definition and framework for measuring care coordination. Available at www.qualityforum.org/projects/care_coordination.aspx. June 2012.Google Scholar
Coleman, EA, Berenson, RA. Lost in transition: challenges and opportunities for improving the quality of transitional care. Ann Intern Med. 2004;141:533–536.CrossRefGoogle ScholarPubMed
2012 Annual Progress Report to Congress – National Strategy for Quality Improvement in Health Care. Corrected August 2012 and May 2014. www.ahrq.gov/workingforquality/nqs/nqs2012annlrpt.pdf. June 2012. (Accessed April 2016)Google Scholar
Ibid.Google Scholar