“Finally Friday!” Observation is Not a Status: What Observation IS and IS NOT

This session was recorded on Friday, November 1, 2013.

 

observation

This fella has no beneficiary number, so CMS won’t pay for Observation, regardless of medical necessity. (Ok, sorry… this is an inside joke with Dr. Salvatore…)

Observation is Not a Status

What Observation IS and IS NOT

This week we wanted to take a hard look at Observation — specifically, what the @#$% is Observation?  EXACTLY? Also, perhaps more importantly, what it is NOT – EXACTLY. It seems to us that since the advent of the 2 Midnight Rule, Observation has taken on a new… well… “status” – sorry, I couldn’t resist the pun.

So, anyway, seriously, we decided to go back and look at the regulations, we bounced around our thoughts, and decided it was time to forget Inpatient for a bit and concentrate a little more on the Outpatient side… which is where Observation lives.

The trouble that we are seeing is that all the short-stay scenarios we keep seeing questions about on the listservs seem to focus on the Inpatient question, and fairly assume that Observation is the default status if you cannot justify Inpatient… for a while. But… all those discussions seem to rather ignore the whole question of the “appropriateness” of placing someone in Observation.

 

 

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