The role of the utilization review (UR) committee has changed as facilities move to reporting condition code W2 for post-discharge reviews, instead of reporting condition code 44 for concurrent reviews.
The 2014 IPPS Final Rule established new regulations for rebilling Part A for inpatient cases denied as not reasonable and necessary, as well as for cases "self-denied" by the provider. Under the new provisions, hospitals can use condition code W2 to rebill Part A claims as Part B claims within one year of a contractor denial or self-audit for dates of service on or after October 1, 2013.
Join HCPro at 1 p.m. Tuesday, December 17, for the live 90-minute audio conference, Utilization Review and the Proper Use of Condition Code 44 and W2. Medicare expert Kimberly Hoy Baker, JD, will help you understand the difference between condition codes W2 and 44, the advantages and disadvantages of each, and how to bill under the new regulations. She will also discuss the structure and function of the UR committee and its role in ensuring proper reimbursement for inpatient care.
For more information or to order, call 800/650-6787 and mention Source Code EZINEAD or visit the HCPro Healthcare Marketplace.