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Attention Inpatient Hospital providers:
The Health Care Authority (HCA) is publishing an updated Inpatient Hospital Services Billing Guide, dated February 1, 2024. The changes to the guide are retroactive to claims with dates of service on and after January 1, 2024
What changed?
- Revised section Hospitals approved for acute withdrawal management services. Added “acute” to the title. Also changed the billing provider taxonomy and revenue code for acute withdrawal management provided in an acute care hospital as follows:
Taxonomy 276400000X changed to 282N00000X
Revenue code 0126 changed to 0120
- Revised section How do I bill for administrative days? Removed the sentence “This does not require PA for FFS clients.” Prior authorization is not required for inpatient administrative days.
- Added new section What charges are allowed during a client’s administrative days stay and a new table for Allowable revenue codes to be used on the administrative day claim.
- Removed note above the Payment methodology table which stated: “To qualify for payment for administrative days related to per-diem-paid services such as PM&R, LTAC, and inpatient psychiatric, the hospital must request PA and bill approved administrative days with rev code 0169 on a separate claim.”
For full details, refer to the What has changed table inside the updated guide, which is located on HCA’s Provider billing guides and fee schedules webpage.
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