The Ensemble Physician Advisory Team shares what you need to know about documenting patient status.
Do |
Don’t |
| IPO List* procedures must remain Inpatient regardless of the length of stay |
Don’t place patients in Observation status before
Outpatient surgery is performed (You are predicting complications) |
|
Remember! As a general rule: Elective Outpatient procedure with no complications Emergent Outpatient procedure with complications; Emergent Outpatient procedure with complications; |
Don’t place post-operative patients in Observation status unless complications arise |
| Get prior approval for all elective surgical procedures when required by the payer |
Routine recovery time does not equal Observation |
| Specify all procedures and CPT codes | Don’t use unspecified codes when scheduling procedures or add on procedures |
| Update CPT codes and Operative notes ASAP for unexpected changes in procedure e.g. conversion from a laparoscopic to an open procedure |
Don’t copy and paste |
• IPO*(Inpatient Only) list created by Medicare includes high risk procedures that must be done in a hospital setting where all specialties are available if needed.
• IPO procedures cannot be done in an office or ambulatory surgical center (ASC).
• For questions about hospitalization status call your Ensemble physician advisor.
