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Author Topic: Question on ancillary services  (Read 2354 times)

Mike Iarrobino

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Question on ancillary services
« on: June 25, 2009, 12:58:05 PM »
I'm posting a question we received from a reader below. Any thoughts?

Quote
When we have ancillary services that are included on an inpatient claim because of the three day rule, should we report the diagnoses for those ancillary services on the claim or should we report only the diagnoses that are coded on the inpatient stay?    If we should include them on the inpatient claim, does it matter the order that we report them?  Is there any documentation that you could refer me to that supports the answers to these questions?  I appreciate any information that you can give me. Thanks.
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Keith Kantner RN, BSN

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Re: Question on ancillary services
« Reply #1 on: June 30, 2009, 11:08:46 AM »
Recommend review of the following from Medicare.  It's "old", but it should still stand.  In addition, there was something posted on the CMS website in January 2008 that referenced these rulings, but I couldn't find it. 

Program Memorandum
Department of Health & Human Services (DHHS)
Intermediaries
Centers for Medicare & Medicaid Services (CMS)
Transmittal A-03-013
Date: FEBRUARY 14, 2003

CMS Manual System
Department of Health & Human Services (DHHS)
Pub. 100-04 Medicare Claims Processing
Centers for Medicare & Medicaid Services (CMS)
Transmittal 156
Date: APRIL 30, 2004
CHANGE REQUEST 3200
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Carol K

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Re: Question on ancillary services
« Reply #2 on: July 29, 2009, 08:40:01 AM »
The diagnoses on the claim should support the medical necessity of all charges, which would include the ancillary services that were "rolled" to the inpatient claim due to the 3-day window rule.  My advise would be to include the ICD codes from the ancillary services on the inpatient claim if you have space for them.  Use the same sequencing rules that you always follow for inpatient claims, i.e., make sure that the CCs and MCCs are  reported as secondary diagnoses, then add others as possible.

We all know that there are many claims on which you cannot report all secondary diagnoses.  That will be improved with the implementation of the HIPAA 5010 standards.
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