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10/04/13

Recovery Auditors will Delay Scrutiny of ‘two-midnight’ Rule

On September 26, 2013, the Centers for Medicare and Medicaid Services (CMS) announced that government recovery auditors will delay scrutiny of short inpatient stays for 90 days while providers get acclimated to the new policy. Recovery auditor contractors have been told by CMS that they will not be allowed to question the medical necessity of inpatient claims lasting a day or less between October 1, 2013 and December 31, 2013. The two-midnights rule says that hospital stays that last two days—defined as a stay that spans at least two midnights—are presumed to be legitimate uses of inpatient care and will

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10/04/13

Acceptable Submission Methods for ADRs

The Centers for Medicare and Medicaid Services (CMS) has issued guidance and clarification on acceptable submission methods when providers receive an additional development request (ADR). The clarification includes information on what documentation submission methods contractors will accept from providers and CMS recommends Medicare contractors to provide an actual physical address instead of a P.O. Box for submission of records, although it is not mandated. To view the methods of submission, click

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10/04/13

ICD-10 Implementation Guide

The Centers for Medicare and Medicaid Services (CMS) has developed an online ICD-10 implementation guide. This web-based tool, released as part of Health IT Week, includes a basic overview of ICD-10 as well as step-by-step guidance on how to transition to ICD-10 for small/medium practices, large practices, small hospitals, and payers. Users can easily navigate to information that is most relevant to them—wherever they are in the implementation process. The online guide also includes links to CMS ICD-10 resources and other tools to help with the ICD-10 transition. To access the guide, click

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