Acute Rehabilitiation Interrupted Stay Compliance

jgizzi

When a Acute rehabilitation hospital transfers a patient at 11:45pm to an acute hospital ED.  The Acute hospital ED sends back to Acute rehab the next morning say 8:00am.  Who is responsible for the bill.  Acute Rehab says they will add one LOA (interrupted stay) day to their UB and we can bill the outpatient ED visit.  This to me seems like a compliance issue.  Thoughts?

ronaldhirsch

I thought you were right (and was ready to write a big comment criticizing the IRF) but I was confusing LTACH and IRF. For LTACH, the LTACH would be responsible for the costs at the acute care hospital. But not for IRFs. Good question though and thanks for forcing me to check my memory.

kay.larsen@ah.org

What about within the hospital?  After a few days on the  Rehab unit, the patient is transferred to a medical unit for a couple of days and then returned to the  Rehab unit until discharge?  Do we submit 3 separate bills?  Rehab, Med and Rehab? 

RHirsch

here is a good summary of the regs- https://www.racmonitor.com/medicare-interrupted-stays-still-troublesome-for-irfs