Physician Note: Difference Between ‘Observation,’ ‘Inpatient,’ and ‘Outpatient’ Became $6 Million Question for Denver Hospital

Plus: Keep PHI out of emails to your MAC.

When your physician admits a patient to the hospital, your coding work isn't done -- you need to know whether the patient was admitted as an inpatient, admitted to observation care, or admitted to the ER (which qualifies as outpatient care). That differentiation cost a Denver hospital over $6 million recently.

Based on a whistleblower lawsuit, the OIG investigated the admission practices of a Denver hospital, which was alleged to be inappropriately admitting patients as "inpatients" when the patients were actually in outpatient or observation status. As most coders know, inpatient reimbursement can typically [...]

- Published on 2012-01-13