Inpatient-Only Procedures Training Handbook Debbie Mackaman, RHIA, CPCO, CCDSPack includes 5 handbooks Compliance with Medicare rules for inpatient-only procedures is a real challenge for hospitals. Staff members from patient access/registration, billing, CDI, utilization review, case management, and compliance all play a role in ensuring patients receiving these procedures are handled properly—and billed for correctly. There are also complexities related to unplanned emergency procedures and procedures that change midway through a surgery. The Inpatient-Only Procedures Training Handbook, by nationally recognized and respected regulatory specialist Debbie Mackaman, RHIA, CPCO, CCDS, analyzes the regulations and provides practical information, strategies, and best practices for ensuring compliance and preventing denials and lost revenue. The handbook format will enable easy distribution of this critical education among departments and staff. Table of ContentsChapter 1:Inpatient-Only Procedure Regulations What is the CMS regulation? How are inpatient-only procedures identified, added, and deleted? Staying up-to-date on annual changes Locating the inpatient-only procedure list Inpatient order requirements Inpatient-only pain points Chapter 2:The Effects on Reimbursement Performing inpatient-only procedures on outpatients Exceptions to the regulation Special implications Critical access hospitals Chapter 3: Creating Best Practices Education: Start at the top Outreach and communication Before a procedure is performed: Scheduling and clinical staff processes Before the patient is discharged: CDI, utilization review, and case management processes Post-discharge: Coding, billing, and audit processes Follow-up: Denials management processes Encourage success Chapter 4: Tools and Resources Draft policy: Identification of inpatient-only procedures Inpatient-only process chart Departmental checklist for identifying inpatient-only procedures Key resources Staff members that would benefit from this resource include: Case managers, compliance auditors/officers, HIM managers and staff, registration/patient access managers and staff, insurance verification/precertification staff, coding/billing managers, billers, business office staff, surgery schedulers, administration, VP clinical, CFO, patient financial services, physician advisors, medical executive committee, UR/UM professionals, CDI staff