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While we generally view the use of additional cost data as improving our OPPS ratesetting process, we have historically not included cost report lines for certain nonstandard cost centers in the OPPS ratesetting database construction when hospitals have reported these nonstandard cost centers on cost report lines that do not correspond to the cost center number

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It has been my understanding that as long as a physician ordered something for a patient and there is documentation in the chart of that, ie shot of B12 or methotrexate for a diagnosed condition that is being followed by the MD, that it is perfectly acceptable for the nurse to give the injection and charge 99211 with the injection J code even if the MD is not present

This represents an indirect mechanism that could enhance the bodys natural repair processes rather than replacing them with an external signal

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