If the attending physician writes an admission order and later decides that the case should have been outpatient and then writes and order for outpatient, do we still need utilization review involvement and condition code 44 to change to observation?
Q: We have an off-campus provider based department that is “non-excepted,” so we have to report modifier –PN (nonexcepted service provided at an off-campus outpatient, provider-based department of a hospital). Is that for just the services that would be paid under the OPPS if the department were “excepted”?
Obtaining appropriate inpatient status orders for inpatient-only procedures can be difficult due to the EMR and written orders that are still in existence. Is it true that if the surgeon or attending physician orders observation/outpatient status after an inpatient-only procedure that we must bill as outpatient? Can we use our utilization review committee to overturn the observation/outpatient order in this scenario? Please advise.
