• | If the second admission is determined unnecessary, reimbursement may be denied. |
• | If the admission was avoidable, the two admissions may be combined and a single diagnosis-related-group (DRG) payment made. |
• | If two different DRG assignments are involved, reimbursement for the appropriate DRG will be based upon review of the case. |
• | Readmissions involving different hospitals will be reviewed by the department and may be paid using the payment method for transfers. |