CodeMap® Radiology Briefing: September 12, 2012
Prior to 2012, the much discussed "72 hour rule" ( aka "3 day payment window") required hospitals to bundle outpatient diagnostic services into the inpatient claim (DRG) for all outpatient services performed within 3 days of the patient's admission. The rule caused much confusion and as of July 1, 2012, has been significantly overhauled and expanded by recent legislation. Now, the rule states that when a physician performs outpatient services in a wholly owned or operated hospital entity (including a physician practice), and the patient is admitted within 3 days as an inpatient, the 3 day payment window policy applies to all diagnostic s....
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