"Example: Patient A was admitted at noon on Sunday. On Monday afternoon it was determined that the patient didn't meet inpatient criteria, the physician concurred, and the status was changed to outpatient. The outpatient status is considered to have begun at noon on Sunday. However, observation hours cannot be billed until the physician has written an order for observation. If the order was written at 2 p.m. on Monday, the hospital would begin the observation hours at that time. No observation can be charged between noon on Sunday and 2 p.m. on Monday."
THank you for your response. My case here is in the order sheets,Patient was admitted to Inpatient on 8/31 and discharged on 9/1 @1227 hrs. After this, there was a note of change patient status from INpatient to Observation on 9/1 at 1243hrs and then a discharge note with the same time. As per CMS code 44 condition : The change in patient status from inpatient to outpatient is made prior to discharge or release, while the beneficiary is still a patient of the hospital; the problem here is the time of discharge is the same with the order of change status. WOuld you consider this as meeting code 44? And I would like to ask also who determines code 44, is it on medical coder's end or code 44 criteria was already decided and met before sending out the bill?