If a patient goes to Interventional Radiology (IR) for declotting, the procedure is unsuccessful and the patient is admitted to the hospital for surgical intervention, how are the services paid?
When an individual is furnished outpatient hospital services and is thereafter admitted as an inpatient of the same hospital, within 24 hours for non-PPS hospitals and within 72 hours for PPS hospitals, the outpatient hospital services furnished are treated as inpatient services unless the patient does not have Part A coverage. The day the patient is formally admitted as an inpatient is counted as the first inpatient day. The composite rate is not paid.
Related Questions
- If a patient is clotted and goes to Interventional Radiology (IR) for declotting only and has a dialysis treatment the next day, does payment for the declot come out of the Composite Rate?
- Hospital declots shunt of an ESRD patient on an outpatient basis. Since this is an ‘inpatient only’ procedure under OPPS, how does the hospital get reimbursed for the service?
- What’s interventional radiology (IR)?
