Wednesday, October 16, 2013 at 10:50:41 AM

The inpatient admission and observation status criteria are changing effective Wed., Oct. 16. Observation is now the “2 midnight rule.” The physician should order Admit to In-patient if the stay is expected to exceed 2 midnights and documentation of medical necessity is present. If the physician cannot reliably predict a stay greater than 2 midnights, the patient should be treated as an outpatient or observation, no matter where the patient is in the hospital. As additional information suggests a longer stay, then the patient can be admitted. Our current Admission Status Process will cease effective this Wednesday, and the new standard physician order form for inpatient admission or observation services will be implemented. It must be completed prior to or at the time the decision is made to place the patient in the hospital and will include the certification components. If “Admit” is written, it will mean observation unless “Admit to In-patient” is stated. Status can change while the patient is here. If the patient refuses the status, then a notice of non-coverage will be issued and the patient can appeal. Care management will be monitoring the process and assisting the physicians with questions.

Return To Home Page