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These Medicare Inpatient Only (IPO) lists by specialty are available for American College of Physician Advisor (ACPA) members. These contain both "inpatient only" procedures and "not inpatient only" procedures in different columns to assist you in identifying the right procedure.
The lists are organized into 16 specialties that are further divided by organ system, anatomic location, or purpose (depending on what makes the most sense for that specialty). Minor procedures that are obviously not inpatient only are sometimes omitted (such as screening colonoscopy or transthoracic echocardiography). Anesthesia, laboratory, and drug codes are, as a rule, omitted from the lists, as well.
Specific highlighting is used within the lists to identify important changes year-over-year. Yellow is used for new codes (whether inpatient only or not inpatient only). Discontinued and non-payable codes for Medicare are removed annually. The presence of the code on the list, however, does not mean Medicare automatically covers the service. Medicare coverage of CPT codes is typically administered at the Medicare Administrative Contractor (MAC) level.
There is also a compilation file of all the specialty specific lists. This will be most useful when searching for a CPT code or a keyword - just use the CTRL-F function in your pdf browser.
Do not post any of these lists on the internet, please. Members may share them with staff at their institutions who can benefit from them, but encourage them to join ACPA for all the other educational and networking opportunities ACPA provides!
The official IPO list remains CMS OPPS Addendum E, and the CPT codeset is owned and maintained by the American Medical Association (AMA). The official references remain the "source of truth" and these ACPA-formatted lists cannot be relied upon as definitive information.
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