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Observation vs admitted

  1. Default Observation vs admitted
    Medical Coding Books
    The patient originally came through ER at 7pm and was assigned to "observation", Pt was then moved to a room on a floor by 3am- (less than 24 hours). Can the facility still bill this as "observation"? They are actually billing the patient's entire 5 day stay as "observation". Is this new? Is it anywhere in the CPT that I can reference? I thought "observation" was routinely 23 hours, with possible extension to 72 hours w/extenuating circumstances. Thanks for any help you can provide!

  2. #2
    Location
    Columbia, MO
    Posts
    12,843
    Default
    Observation status is dependent on a physician order. If the physician did not write an order to admit to the inpatient setting then it is still observation. Any bed within the facility can be an observation bed.

    Debra A. Mitchell, MSPH, CPC-H

  3. Default
    Thanks Debra! That gives me a direction to work in toward getting this resolved for the patient and family! Appreciate it!

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