lfuller
Networker
Can someone explain to me the documentation requirements if a patient is
admitted to observation, then status changes to inpt the next day, by the
SAME doctor. Does the doctor have to dictate a new H&P? An H&P has
already been done. Is it appropriate for the dr to reference the observation H&P and
then dictate the next day's findings? I trying to find the easiest way for them to document.
Thanks.
admitted to observation, then status changes to inpt the next day, by the
SAME doctor. Does the doctor have to dictate a new H&P? An H&P has
already been done. Is it appropriate for the dr to reference the observation H&P and
then dictate the next day's findings? I trying to find the easiest way for them to document.
Thanks.
Last edited: