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from Section 1 - Administration
Published online by Cambridge University Press: 27 June 2025
Chapter 2 gives an overview/background of observation, notes the growth/development of observation then discusses administrative issues associated with observation including the Centers for Medicare and Medicaid (CMS) definition of observation, the two-midnight rule, simple vs. complex/extended observation, the PEPPER Report, Medical Necessity, changes in observation status: from inpatient to outpatient and from outpatient to inpatient, the inpatient prospective payment system, payment errors, targeting short inpatient stays, reimbursement, comprehensive error rate testing (CERT), QIOs and the controversy regarding observation. A glossary of terms is also included.
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