Certified Inpatient Coding (CIC) Practice Exam

Under which Medicare rule will the technical component of a left heart catheterization be bundled into an inpatient stay?

1. Hospital Issued Notices of Non-Coverage

2. Readmission Reduction Program

3. Two Midnight rule

4. Three day payment window

The correct answer is: Three day payment window

The correct choice highlights the concept of the Three Day Payment Window. This rule stipulates that any outpatient services related to a hospital admission that occur within three days prior to the inpatient stay are included in the bundled payment for that inpatient admission. This is significant because it ensures that the technical component of procedures like left heart catheterization, which may be performed in an outpatient setting before an inpatient admission, is bundled into the overall payment that the hospital receives for the inpatient stay. This bundling means that the hospital will not receive separate reimbursement for these procedures if they were performed under outpatient status within the defined timeframe prior to the inpatient admission. It simplifies the billing process and provides a more comprehensive payment structure for the full episode of care provided to the patient during their inpatient stay. In contrast, the other options do not pertain to the bundling of technical components of procedures into inpatient stays in this manner. Hospital Issued Notices of Non-Coverage are used to inform patients about non-covered services. The Readmission Reduction Program is aimed at minimizing hospital readmissions to improve patient care and reduce costs. The Two Midnight rule relates to the determination of whether a patient should be admitted as an inpatient or treated as outpatient observation based on the anticipated duration of care, rather