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OBSERVATION VISITSFrom: Wilma Harrell (wharrell74@aol.com)Wed Aug 13 13:30:53 2003
ALL patients who present to L&D on the weekends and weekday nights are admitted as "observation". I don't know why, but this is what occurs. It does not matter how trivial the complaint is, or how quickly it is resolved...ALL are admitted to "observation" as a matter of protocol. Who made the protocol is another question. A 16 yo who is full term presents for vaginal itching. An NST is automatically performed (protocol). I arrive at the psatient's bedside, perform a speculum exam, confirm a yeast infection, and interpret the NST. I spend 20 minutes at the patient's bedside. IF THE PATIENT IS TRULY "OBSERVATION" THEN I CANNOT BE PAID UNLESS I DICTATE AN ENTIRE H&P FOR A RIDICULOUS YEAST INFECTION. IF THIS PATIENT IS CALLED "OBSERVATION" BUT IS ACTUALLY AN "OUTPATIENT" I CAN DICTATE A SIMPLE NOTE INCLUDING THE TIME SPENT AT THE BEDSIDE AND CHARGE AN "OUTPATIENT" CODE. These ridiculous situations are endless. The list goes on and on...yeast infections, heart burn, nausea, headache. None of these 20-30 minute visits necessitate an H&P. Why should I have to jump through these hoops? Is it incorrect to label each patient (no matter what) as observation? Is it incorrect to call it "observation" when it's really just an "outpatient" type visit? For the purposes of medicaid, can these be billed with "outpatient" codes inspite of the "observation" misnomer?
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