CMS is reexamining inpatient criteria because it has seen a significant increase in the number of patients spending more than 24 hours in observation. Providers are worried that a Recovery Auditor will deny a short inpatient stay for lack of medical necessity and recoup payment years later. So instead, some facilities place patients in observation for longer time periods.
Coders will see plenty of changes when they start using ICD-10-CM codes. Many codes require more specific information, such as laterality, stage, or encounter.
