Medicare Benefit Policy Manual (Pub. 100-02), Ch. 2 § 20

Admission Requirements

Last amended: 2018Year: 2018Length: 188 wordsOfficial source
20 - Admission Requirements (Rev. 253, Issued: 12- 14-18, Effective: 01-16-19, Implementation: 01- 16-19) In accordance with 42 CFR 412.27(c), for all IPFs, a provisional or admitting diagnosis must be made on every patient at the time of admission, and must include the diagnosis of comorbid conditions as well as the psychiatric diagnosis. The reasons for admission must be clearly documented as stated by the patient or others significantly involved, or both. Psychiatric hospitals are required to be primarily engaged in providing, by or under the supervision of a psychiatrist, psychiatric services for the diagnosis and treatment of mentally ill persons, according to 42 CFR 412.23(a). Distinct part psychiatric units of acute care hospitals and CAHs are required to admit only those patients whose admission to the unit is required for active treatment, of an intensity that can be provided appropriately only in an inpatient hospital setting, of a psychiatric principal diagnosis that is listed in the International Classification of Diseases, Tenth Revision, Clinical Modification. As a condition for Medicare payment, all admissions to IPFs must be certified and recertified by a physician, as detailed in section 30.2.1.
Medicare Benefit Policy Manual (Pub. 100-02), Ch. 2 § 20: Admission Requirements | Justis AI