Harbor:Interqual Override Notes: Difference between revisions
(Created page with "Interqual Override Notes *Secondary review of case by attending/fellow not caring directly for patient *Each denied day loses hospital ~$5000/day *Be specific about need for i...") |
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Interqual Override Notes | Interqual Override Notes | ||
*Secondary review of case by attending/fellow not caring directly for patient | *Background | ||
*Each denied day loses hospital ~$5000/day | **Secondary review of case by attending/fellow not caring directly for patient | ||
**Each denied day loses hospital ~$5000/day | |||
**May get denied still because doing obs/short stay and CORE upstairs, and not having surgical obs upstairs | **May get denied still because doing obs/short stay and CORE upstairs, and not having surgical obs upstairs | ||
*Note: | |||
**Be specific about need for inpatient admission, diagnosis, illness severity, complexity | |||
**"Patient needs admission for_" | |||
**Try not to use the words "monitoring, observation, work up" which get denied | |||
*Common examples: | *Common examples: | ||
**Acute CHF exacerbation requiring IV diuresis | **Acute CHF exacerbation requiring IV diuresis | ||
Revision as of 19:32, 3 November 2020
Interqual Override Notes
- Background
- Secondary review of case by attending/fellow not caring directly for patient
- Each denied day loses hospital ~$5000/day
- May get denied still because doing obs/short stay and CORE upstairs, and not having surgical obs upstairs
- Note:
- Be specific about need for inpatient admission, diagnosis, illness severity, complexity
- "Patient needs admission for_"
- Try not to use the words "monitoring, observation, work up" which get denied
- Common examples:
- Acute CHF exacerbation requiring IV diuresis
- Cellulitis, pyelonephritis, pneumonia requiring IV antibiotics, failed outpatient antibiotics, hardware infection, immune compromised
- Acute cholecystiis, appendicitis requiring IV antibiotics and inpatient surgical management
- NSTEMI requiring anticoagulation, urgent cardiac cath
- Hypotension requiring IVF, pressors