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One Day IP Stays

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jc071172:
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.

Michele:
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?

jc071172:
The criteria that constitutes a ODS.

Michele:
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/ 

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