CEREBROSPINALECTOMY
Case manager: "He does not meet inpatient criteria."
Me: "He cannot walk."
Case manager: "Since when?"
Me: "Since yesterday. That is the reason he is here."
Case manager: "Is it expected to last two midnights?"
Me: "I am a neurologist, not a fortune teller. And also yes."
Send this to the case manager you actually like.
EXPLAINED (ACCURACY-CHECKED)
Under the Medicare two-midnight rule, inpatient admission status turns on the physician's expectation that medically necessary care will span two midnights, which requires a prospective prediction about an unpredictable course.
Accurate statement of the CMS two-midnight benchmark and its prospective-expectation requirement.
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