Join expert speaker Kimberly Anderwood Hoy Baker, JD, CPC, as she discusses operational strategies for using condition code 44 and W2 processes to get reimbursement for inpatient non-covered cases while leveraging UR resources. She will offer tips for concurrent and post-discharge review, including the interface between UR and coding and billing. She will also break down case studies to compare payment using condition codes 44 and W2.

At the conclusion of this program, you will be able to: 

• Explain two differences between billing mechanisms for condition codes 44 and W2 
• Identify the three requirements for use of condition code W2 
• Name the three entities that must receive notice after a self-denial by the UR committee 
• Articulate the differences in patient financial liability for inpatient Part A, inpatient Part B, and outpatient Part B 

Agenda 

• Discussion of strategies and rationale for using condition code W2 rather than condition code 44 
• The financial impact of using condition code W2 vs. condition code 44 from the patient’s and the hospital’s perspective 
• Processes for moving away from condition code 44 and operationalizing condition code W2 
• Case studies to illustrate the impact of condition codes W2 and 44 on the patient and facility 

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