Condition Code 44: Changing an Inpatient to Outpatient for Traditional Medicare
When a Traditional Medicare inpatient admission does not meet medical necessity, Condition Code 44 (CC44) lets hospitals change the patient to outpatient and bill Part B. It must happen before discharge, and the attending must agree.
Our UR Documentation Tip Sheet give your team a quick reference for:
- Who makes the determination, and who can enter the order
- What to document in the business record
- When CC44 can and cannot be used
- Required notices after CC44 (MOON and MCSN) and their timing
