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Providers must track which payer covers which service types to avoid crossover claim denials

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Under this policy, procedures removed from the IPO list are exempted from site-of-service claim denials, Medicare review contractor referrals to the Recovery Audit Contractor (RAC) for persistent noncompliance with the 2-midnight rule, and RAC reviews for patient status (that is, site-of-service) until claims data demonstrates that the procedures are more commonly billed in the outpatient setting than the inpatient setting

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