Wiki Observation Stay

[Linda77]

Does anyone know exactly up to how long an Obs stay can be? I always thought it was 72 hrs but I am starting to see up to a week in Obs. Does anyone have info on this? Thanks

 

[Daniel Rowden]

There is no "defined" limit. Medicare and other payers have "limits" on what they will pay up to however some will allow outliers. Technically anyone who is expected to stay overnight should be admitted as inpatient however a lot of places leave people in observation for days or even up to a week. There is a big debate as to whether this is over use of observation services. The potential for hospitals to receive more money is higher when a patient is in outpatient status versus inpatient.

In my work I work reviewing facility charges, anything that is more than 72 hours of observation throws up a flag for potential audit for an institution that we receive several of these from. They should have been stable and discharged or upgraded to inpatient by that point if they needed to stay longer. I also find as a coder who works in a payer setting that some coders/billers have a very difficult time with observation and inpatient. I too often see facility charges and the documentation not agreeing about the status.

 

[Linda77]

Thank You for the info