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  1. QRDA Issue Tracker
  2. QRDA-1289

CMS 506 - Observation Order vs Inpatient Order with Inpatient Billing

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    • Icon: Question/Guidance Question/Guidance
    • Resolution: Resolved
    • Icon: Moderate Moderate
    • None
    • None
    • CMS0506v6
    • Observation Order Date/Time vs Inpatient Order Date/Time Relevance
    • Teresa Francis

      During validation of the EHR and the QRDA for the above topic.  I discovered that the admission orders in the EHR are as follows:

      Patient Placement Order 9/5/24 @ 1605; Patient Class: Observation; Level of Care: Med-Surg

      Transfer Order 9/5/24 @ 1736; Patient Class: Inpatient; Level of Care: Intensive Care Unit

      Transfer Order 9/5/24 @ 1806; Patient Class: Inpatient; Level of Care: Intermediate Care

      Update Patient Status Order 9/6/24 @ 1547; Patient Class: Inpatient; Level of Care: Intermediate Care

       

      QRDA indicates the following:

      2.16.840.1.113762.1.4.1111.143 Observation Services

      Admission Source Code - NULL

      Code - SNOMEDCT 448951000124107

      DC Disposition - NULL

      Principal Dx - NULL

      Relevant Period/Interval Date/Time - 9/5/24 04:05 PM, 9/5/24 06:06 PM

      2.16.840.1.113883.3.666.5.307 Encounter Inpatient

      Admission Source Code - NULL

      Discharge Disposition - NULL

      Principal Dx - NULL

      Relevant Period/Interval Date/Time - 9/5/24 06:06 PM, 9/7/24 01:35 PM

       

      The Observation Information in the QRDA appears to be correct.  However, the Inpatient Information has the date/time of the second "transfer order" instead of the first "transfer order".  Which order is the accurate utilization of the inpatient date/time?  Is the date/time for the initial inpatient order, correct?  Which order is considered priority?

       

       

            yanheras Yan Heras
            frante Teresa
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              Created:
              Updated:
              Resolved: