Harbor:Interqual Override Notes

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 inpatient admission, diagnosis, illness severity, complexity
• "Patient needs admission for_"
• Try not to use the words "monitoring, observation, work up" which get denied
  • May get denied still because doing obs/short stay and CORE upstairs, and not having surgical obs upstairs
• 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