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Review of Hospital Compliance with Medicare's Transfer Policy with the Resumption of Home Health Services and the Use of Condition Codes (A-04-18-04067)

The current Office of Inspector General (OIG) audit, August 2020 Report No. A-04-18-04067, https://oig.hhs.gov/oas/reports/region4/41804067.pdf identifies Medicare overpayments to hospitals that did not comply with Medicare's post-acute-care transfer policy (transfer policy). This article reminds hospitals of proper coding of the patient discharge status code and the use of condition codes 42 and 43.

Download the Guidance Document

Issued by: Centers for Medicare & Medicaid Services (CMS)

Issue Date: December 01, 2020

DISCLAIMER: The contents of this database lack the force and effect of law, except as authorized by law (including Medicare Advantage Rate Announcements and Advance Notices) or as specifically incorporated into a contract. The Department may not cite, use, or rely on any guidance that is not posted on the guidance repository, except to establish historical facts.