Time frame Hybrid 24 hours is not a match to what is allowed on claims

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    • Type: Value Sets
    • Resolution: Unresolved
    • Priority: Moderate
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      I don't think hospitals should be held to an APU penalty for a measure logic nuance. We are finding that patients are getting a weight but fall out side of the 24 hours from IP, even by an hour, since it was taken it should be considered.

      If "On the inpatient claim, a valid "from" date could be up to and including 3-days (or 1 day) prior to the actual inpatient admission based on the pre-admission bundling rule"

      Then the time frame for the "matching" claims measure should also allow values from that time period.

      https://med.noridianmedicare.com/web/jfa/provider-types/acute-ipps-hospital/admission-date-and-statement-covers-period-billing#:~:text=The%20day%20on%20which%20the%20patient%20is%20formally,or%20837I%20Loop%202300%2C%20Segment%20DTP%20%28electronic%20submission%29
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      I don't think hospitals should be held to an APU penalty for a measure logic nuance. We are finding that patients are getting a weight but fall out side of the 24 hours from IP, even by an hour, since it was taken it should be considered. If "On the inpatient claim, a valid "from" date could be up to and including 3-days (or 1 day) prior to the actual inpatient admission based on the pre-admission bundling rule" Then the time frame for the "matching" claims measure should also allow values from that time period. https://med.noridianmedicare.com/web/jfa/provider-types/acute-ipps-hospital/admission-date-and-statement-covers-period-billing#:~:text=The%20day%20on%20which%20the%20patient%20is%20formally,or%20837I%20Loop%202300%2C%20Segment%20DTP%20%28electronic%20submission%29
    • UW Medicine
    • Change time frame from 24 hours prior to 72.

          Assignee:
          Ariel Williams (Inactive)
          Reporter:
          Chira Vathanaprida (Inactive)
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            Created:
            Updated: