Question

Hospital and billing requirements under medical necessity require that the medical necessity be justified before a procedure is performed and that applies to both ___ and ____.

A. Inpatients; outpatients
B. Emergency cases; elective cases
C. Medicare patients; private insurance patients
D. Diagnostic tests; therapeutic interventions

Answer 1

The correct answer is A. Inpatients; outpatients. Hospital and billing requirements under medical necessity require that the medical necessity be justified before a procedure is performed, whether the patient is an inpatient or an outpatient.

Step-by-step explanation:

The correct answer is A. Inpatients; outpatients.

Hospital and billing requirements under medical necessity require that the medical necessity be justified before a procedure is performed. This applies to both inpatients (those admitted to the hospital for an overnight stay) and outpatients (those receiving medical care without being admitted to the hospital).

For example, if a patient needs a diagnostic test like an MRI or a therapeutic intervention like a surgery, the medical necessity for these procedures must be justified before they are performed, regardless of whether the patient is an inpatient or an outpatient.