Author Topic: Observation Status  (Read 1009 times)


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Observation Status
« on: June 28, 2012, 12:00:57 PM »
Good Morning,

I am new to Utilization review but have a question about what can be bill under observation status.....

Can all services for care be billed under observation using the following scenario?

1. Patient comes in through the ER
2. Patient is placed on observation status
3. Patient has a surgical procedure performed (that does not require an inpatient stay)
4. Patient is released from observation status to home. Total visit is less than 23 hours of care.....

Is this type of process reimbursable as an observation visit only or does the patient need to be admitted to the ward for the surgical piece in order to get reimbursed completely?

Thank you