Published
The Medicare 72-hour rule states that if a patient receives outpatient services three days before a hospital admission, the facility cannot bill Medicare for the outpatient services. Rather, the services are included in the inpatient diagnosis-related group (DRG) payment.
This rule applies when the hospital where the patient is admitted--or a facility that the hospital wholly owns or operates--provides the preadmission services. Although commonly called the "72-hour rule," it actually applies to services rendered three calendar days before admission, not the 72-hour time period that immediately precedes the hour of admission.
Under this rule,
diagnostic services provided within three days of admission should be included in the DRG, whether or not they are related to the admission
non-diagnostic services provided within three days of admission should be included in the DRG only if they are related to the admission
all non-diagnostic services that are unrelated to the admission can be billed separately
osusana
9 Posts
I found the website for the 72 hour rule, if anyone needs any info on it.
www\himinfo_com HCFA's 72-hour rule clarification The good, the bad, and the ugly.htm