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Identify the three requirements for use of condition code W2.

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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

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Take-home tools:

CoP compliant UR determination form
Patient UR determination letter
Procedure for UR determination for non-covered inpatient cases

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