Coding and Reimbursement Basics for the Interventionalist-The Inpatient Only List: What You Need to Know

The Inpatient Only List: What You Need to Know

Video Transcription

Video Summary

The inpatient-only (IPO) list is an annual Medicare policy that includes procedures requiring an inpatient level of care. It is based on factors like the nature of the procedure, severity of underlying conditions, and postoperative recovery time. Following this list is crucial for reimbursement. Procedures on the IPO list can only be performed as inpatient procedures, not outpatient. The list is part of the Outpatient Prospective Payment System and is released yearly with proposed and final rules. CMS has provided a policy for removing procedures from the list based on certain criteria. It's important to communicate with the hospital to ensure correct patient status and reimbursement. Other insurers, like Medicaid, may also follow the IPO list.

Keywords

inpatient-only list

Medicare policy

inpatient level of care

reimbursement

Outpatient Prospective Payment System