Patient Status and Inpatient Admission Orders: Interpreting the Latest Regulations - On-Demand

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Patient Status and Inpatient Admission Orders: Interpreting the Latest Regulations - On-Demand

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Patient Status and Inpatient Admission Orders: Interpreting the Latest Regulations - On-Demand

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Available ON-DEMAND

Presented on:
Thursday, November 8, 2018

Presented by:
Kimberly A. H. Baker, JD, CPC
Ralph Wuebker, MD, MBA 

Sponsored by: RCA, NAHRI

Hospitals continue to struggle with applying CMS’ patient status guidelines and 2-midnight rule requirements in real-world—and often high-pressure—situations. Although recent changes to inpatient admission order requirements in the 2019 IPPS final rule may ease some of the burden in the short term, the final rule left several significant questions unanswered and failed to address providers’ other long-standing issues with the 2-midnight rule.

Learn how to create efficient, tested, and compliant processes for patient status determinations and 2-midnight compliance by joining expert speakers Kimberly A. H. Baker, JD, CPC, and Ralph Wuebker, MD, MBA, for this 90-minute webinar. Baker and Wuebker will put CMS’ regulations in context and explain how to leverage physician advisors and the utilization review (UR) committee to monitor compliance and ensure success. They will also answer audience questions during the live Q&A.

At the conclusion of this program, participants will be able to:

  • Explain CMS’ patient status and observation regulations
  • Identify inpatient admission order requirements and updates
  • Describe planned changes to the inpatient-only list for 2019
  • Define observation status and the 2-midnight rule
  • Describe the role of physician advisors in monitoring patient status compliance


  • Exploring definitions and regulations for observation status and the 2-midnight rule
    • Are two nights of observation inpatient? Yes, but …
    • Documentation issues around delays and admissions for placement or convenience
    • Does no safe discharge mean hospital care is medically necessary?
  • Analysis of the removal of physician order requirement as a condition of payment
    • Understanding the impact of the 2019 IPPS final rule
    • Is an inpatient order still necessary?
    • Should you change current physician order policies?
  • Understanding the inpatient-only list and the most recent changes
    • What does it mean when codes are added or removed from the inpatient-only list?
    • Review of changes for 2018, including total knee procedures (27447) and anesthesia (01402)
    • Proposed changes for 2019
  • Recognizing and leveraging the role of physician advisors in monitoring patient status compliance
  • Live Q&A

Continuing Education

(Live + On-Demand) This program has been approved for 1.5 continuing education unit(s) for use in fulfilling the continuing education requirements of the American Health Information Management Association (AHIMA). Granting prior approval from AHIMA does not constitute endorsement of the program content or its program sponsor.

Ability to claim credits for this webcast expires on: 11/07/2019

(Live + On-Demand) This program has the prior approval of AAPC for 1.5 continuing education hours. Granting of prior approval in no way constitutes endorsement by AAPC of the program content or the program sponsor.

Ability to claim credits for this webcast expires on: 11/07/2019


  • Generic metric scorecard for physicians
  • CMS 2-midnight algorithm

Who Should Listen?

  • UR committee
  • UR staff
  • Physician advisors
  • Case managers
  • Coding managers
  • Coders
  • Appeals staff
  • Denials staff
  • Revenue integrity staff
  • Revenue integrity managers/directors
  • Revenue cycle staff
  • Revenue cycle managers/directors

Meet the Speakers

Kimberly Baker

Kimberly A. H. Baker, JD, CPC, is the director of Medicare and compliance for HCPro. She is a lead regulatory specialist for HCPro's Revenue Cycle Advisor and is the lead instructor for HCPro's Medicare Boot Camp®—Hospital Version, Medicare Boot Camp®—Utilization Review Version, and HCPro’s Medicare Boot Camp®—Provider-Based Department Version. She is a former hospital compliance officer and in-house legal counsel and has over 25 years of healthcare experience, including 10 years of experience teaching, speaking, and writing about Medicare coverage, payment, and coding regulations and requirements.

Ralph Wuebker

Ralph Wuebker, MD, MBA, is chief medical officer for EHR in Newtown Square, Pennsylvania. He is board-certified and currently serves as a member of EHR’s physician education and audit team. Wuebker regularly visits EHR’s client hospitals to provide medical executives and staff members with ongoing education on a variety of topics, including Medicare and Medicaid compliance and regulations, medical necessity, Recovery Audit Contractors, utilization review, denials management, and length of stay.


Webinar system requirements and program materials: 
To fully benefit from the webinar experience, please note you will need a computer equipped with the following:

Browser: Microsoft Internet Explorer 6 or later, Firefox, Chrome, or Safari, with JavaScript enabled 
Internet: 56K or faster Internet connection (high-speed connection recommended) 
Streaming: for audio/video streaming, Adobe Flash plug-in or Safari browser on iOS devices 

Prior to the webinar, you will receive an email with detailed system requirements, your login information, presentation slides, and other materials that you can print and distribute to all attendees at your location. 

No problem. The On-Demand version will be available. Use it as a training tool at your convenience—whenever your new or existing staff need a refresher or need to understand a new concept. Play it once or dozens of times. A $259 value! 

Participation in the webinar is just $259 per site. All materials must be retrieved from the Internet. 

Call your customer service representative toll-free 800-650-6787 or email if you have questions.