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RAC Tip: How to Determine Inpatient Admission Date, Time

James Carroll, for HealthLeaders Media, February 14, 2011

"Presumably, this would also mean that if the admission order is written on one date of service, but the patient is not placed in the inpatient bed until the following date, the date of admission for purposes of assessing room and board charges would be the date of the inpatient order for care," she says.

She continued: "In addition, all orders are required to be timed and dated according to the Medicare Conditions of Participation and JCAHO,therefore the date and time of the actual inpatient order is when the patient becomes an inpatient, regardless if the order was written just prior to midnight or where the care is being given."

In addition, keep in mind that "inpatient" is a status and level of care, and not necessarily a place of service. If the following day is used instead of the actual date as in the above example, other issues may arise and should be considered, according to Mackaman. These include

  •         potentially missing the "three-day qualifying stay" for skilled nursing facility admission;
  •         reporting actual benefit days for the patient;
  •         reporting the actual length-of-stay statistics for the facility;
  •         and application of the MS-DRG transfer and post-acute care transfer (PACT) rules.

Hospitals should be cautious about waiting for the patient to be placed in an inpatient bed in a unit instead of using the actual date of the inpatient order, she added.


James Carroll is associate editor for the HCPro Revenue Cycle Institute.

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