Obtaining appropriate inpatient status orders for inpatient-only procedures can be difficult due to the EMR and written orders that are still in existence. Is it true that if the surgeon or attending physician orders observation/outpatient status after an inpatient-only procedure that we must bill as outpatient? Can we use our utilization review committee to overturn the observation/outpatient order in this scenario? Please advise.
On Mondays, the facility where I work performs a self-audit on one- and two-day admissions that occurred over the weekend. We do this before the bill is dropped. If we find that an inpatient admission should have observation or outpatient, the billing department uses the appropriate codes for the claim and bills for Medicare Part B. Should we notify the patient of this change? Do we need to involve the physician who wrote the order?
