tci ED Coding & Reimbursement Alert - 2009 Issue 2

You Be the Coder: Observation or ED E/M Care?

Question: A 68-year-old patient with significant airflow limitation due to obstructive chronic bronchitis 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 -- and then decides to admit the patient to observation status. Initially, the oxygen saturation is satisfactory and the physician starts the patient on antibiotics and bronchodilators by inhalation. After spending nine hours in observation (10 a.m. to 7 p.m.), the patient's condition begins to deteriorate, his oxygen saturation falls, and the ED physician decides the patient...

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