tci ED Coding & Reimbursement Alert - 2012 Issue 12

Reader Question: Can you report an observation service if the patient is subsequently admitted?

Question: A 65-year-old patient with significant airflow limitation due to chronic bronchitis and emphysema is admitted to observation for acute bronchitis. The ED physician performs a comprehensive history and a comprehensive examination along with medical decision-making of high complexity, the ED physician decides to admit the patient to observation status. Initially, the saturation is satisfactory and the physician starts the patient on antibiotics and bronchodilators by inhalation. After spending 8 hours in observation from 10 AM to 6 PM, the patient's condition begins to deteriorate, the O2 saturation falls and the emergency physician decides the patient needs to be...

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