Coding, Classification and Reimbursement

Timeliness of IP order

  • 1.  Timeliness of IP order

    Posted 01-08-2019 16:00
    I have a situation that I am not comfortable with. Patient was admitted to OBS for threatened labor. Patient went on to deliver and was discharged 3 days later. MD did not write an order to change the patient from OBS to IP status. An IP order was written 87 days after admission and signed by MD 14 days after that. MD also added a note to the chart the same day he signed the order (101 days after admission), stating the reason the patient was changed to IP status. Do I have a valid IP order? Does the facility need to just accept that they will only get reimbursed for an OBS visit?

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    Ellen Elia, RHIT CPC COBGC
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  • 2.  RE: Timeliness of IP order

    Posted 01-15-2019 09:51
    ​It may depend on the payer.  Was the order present prior to the claim being filed? If there was no order for IP care, they could easily deny the IP stay.  If it were a Medicare patient, was the two midnight certification present in the record.   Other payers "don't care" what the physician ordered - they will pay per their policy.

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    Susan Roehl
    Consultant
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