Thank you for the inquiry. ​The appropriate documentation for the decision to admit inpatient includes: Decision to Admit: Documentation of the decision to admit the patient from the ED that is closest to the inpatient admission and since admission processes vary at different hospitals this can use either of the following: 1. An Order- A) admission order (this may be an operational order rather than the hospital admission to inpatient status order), B) disposition order (must explicitly state to admit), C) documented bed request, or D) documented acceptance from admitting physician. This is not the "bed assignment time" or "report called time". Or 2. An Assessment- an ED evaluation that results in a decision to "Admit Inpatient" The decision to admit order includes these codes: 73607007 Hospital admission, emergency, from emergency room (procedure) 19951005 Hospital admission, emergency, from emergency room, medical nature (procedure) 10378005 Hospital admission, emergency, from emergency room, accidental injury (procedure) 432661000124104 Hospital admission, transfer from emergency department (procedure) And the assessment should include these codes with a decision to admit inpatient: 83818-5 Attending Emergency department Note 80746-1 Emergency department Plan of care note 74211-4 Emergency department+Hospital Summary of episode note 78337-3 Emergency department Initial evaluation note 78249-0 Emergency department Admission history and physical note 78307-6 Emergency department History and physical note 80741-2 Emergency medicine Emergency department Plan of care note 34878-9 Emergency medicine Note 68552-9 Emergency medicine Emergency department Admission evaluation note 28568-4 Physician Emergency department Note 51846-4 Emergency department Consult note 54094-8 Emergency department Triage note 34111-5 Emergency department Note 78341-5 Emergency department Transfer summary note  with a result of one of the following: 707852009 Inpatient management required (finding) 434081000124108 Patient requires hospitalization (finding) 452541000124103 Transition of care from emergency department to acute care (finding) The decision to admit inpatient must be performed during the ED visit that is within one hour of the inpatient admission and prior to the patient departing the ED. The specification provides elements from the clinical electronic record required to calculate the median time, i.e., the duration from the decision to admit to the time the patient physically departed the ED.