Wiki Outpatient Observation Vs Same Day Surgery Status

[Gkowal]

My doctor is inquiring on why his patient who went through the E.R with appendicitis would go from an outpatient observation status to a same day surgery status? She ended up being a 23 hour stay and did have an appendectomy. The coding department called him and asked him to change his orders so they can switch the patient to a same day surgery status. He has operated on patients previously who remained in outpatient observation status, but wanted to understand the significance of changing to same day surgery status. This facility is a hospital, surgery took place in the outpatient surgery unit. Patient was released after 23 hours. Any clarification and explanation for the status change would be appreciated. Thank you.

Gina K

 

[pwerdin]

There is a couple things that are going on here..back end stats will be more accurate as a same day surgery patient..you will not get separate reimbursement for the obs stay..will be bundled in the surgery..surgery hours need to be carved out of the obs hours because of other close monitoring rules anyway..obs is still reported but not payable. The surgery has a global recovery time attached..anything over and above needs to be documented why patient was not discharged at end of recovery period..