Per the AAPC CEDC Practicum, additional workup in the ED does not include results available during the ED visit.
Some examples of additional workup include a scheduled appointment or testing post ED documented by the ED provider, admission to inpatient or observation status and transfer to another facility or to the OR.
There are organizations that assign additional workup planned when three or more ancillary studies or a special study (CT, MRI, US) are ordered.
To answer your question about never getting 4+ points, I never say never. A patient presenting with a finger lac requiring sutures could experience Status Epilepticus resulting in an admission.
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