|July 2006 · Vol. 18, No. 7
Correct coding when the patient goes to ER
RN, CPC-OGS, MA
Admitting the patient to observation status is not the same as admission to the hospital
Independent coding and documentation consultant; former program manager, Department of Coding and Nomenclature, American College of Obstetricians and Gynecologists
Q My patient who was 7 months pregnant presented to the ER with abdominal pain. She was sent to labor and delivery, where I treated and discharged her. Should I use the observation codes for this or just an outpatient visit code?
A You need to determine whether you admitted the patient to observation status (which is not the same thing as admission to the hospital) or saw the patient, treated her, and then sent her home.