Medical Billing Forum

General Category => General Questions => : jc071172 July 17, 2012, 01:15:15 PM

: One Day IP Stays
: jc071172 July 17, 2012, 01:15:15 PM

I was wondering how everyone else out there defines One Day IP Stays. We define them as:

1. TOB = 111
2. LOS = 1 or LOS = 0
3. DRG = Must be coded.
4. Room Charge = At least one room charge.

I would like to get anyone else's thoughts as well as if anyone has any scenarios where they have a Ins. Payer that sets a guideline on how they define a ODS and you have to meet that guideline in order to get the actual contracted rate for a ODS. Thanks.

: Re: One Day IP Stays
: Michele July 17, 2012, 09:03:34 PM

I'm not sure if you are asking about the criteria to determine if it constitutes an inpatient stay or if you are just asking on the coding?

: Re: One Day IP Stays
: jc071172 July 18, 2012, 11:16:29 AM

The criteria that constitutes a ODS.

: Re: One Day IP Stays
: Michele July 19, 2012, 01:57:29 PM

I am not sure of the criteria but I found this article that may be helpful:

http://cmahealthpolicy.com/2010/05/24/when-is-a-hospital-inpatient-stay-not-an-inpatient-hospital-stay-hospital-observation-services/