Ariz. Admin. Code § 9-22-712.78
Current through Register Vol. 30, No. 37, September 13, 2024
If a member is readmitted without prior authorization to the same hospital that the member was discharged from within 72 hours and the DRG code assigned to the claim for the prior admission has the same first three digits as the DRG code assigned to the claim for the readmission, then payment for the claim for the readmission will be disallowed only if the readmission could have been prevented by the hospital.
Ariz. Admin. Code § R9-22-712.78