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October 2022
Related outpatient services performed 24 hours prior to admission are included in inpatient claimBlue Cross Blue Shield of Michigan payment policy requires that certain outpatient services performed within 24 hours prior to an admission be included in the inpatient claim. This payment policy applies when the outpatient and inpatient services are performed in the same facility. Services provided in the outpatient department within 24 hours prior to an inpatient admission are paid as part of the inpatient admission when the diagnosis is the same. Claims submitted for outpatient services within 24 hours prior to admission may receive a denial as they shouldn’t be billed separately. |
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