OMOP Vocabulary in the visit domain have three high level concepts
The standard vocabulary - CMS place of service - rolls up to these top level concepts.
I observed today that the conceptId ‘Observation Room’ 581385 maps up to ‘Outpatient Hospital’ and then to ‘Outpatient Visit’.
This seems counter intuitive to me - because when I used to work in the ER the patients Observation Room was usually a physical place in the Emergency room, where a person would be observed for several hours. Patients commonly stay overnight in observation room (i.e. they would sleep in the hospital/ER). Common scenarios of - patients with chest pain and waiting for three troponin blood draws to be below threshold, or patients with MI but the hospital does not have a bed yet to take them. etc.
In addition, guidance for coding for Observation room here Article - Billing and Coding: Acute Care: Inpatient, Observation and Treatment Room Services (A52985) seems to also suggest that it should not be used for elective visits eg…
Per CR 6492 (and the manual): “General standing orders for observation services following all outpatient surgery are not recognized. Hospitals should not report as observation care, services that are part of another Part B service, such as postoperative monitoring during a standard recovery period (e.g., 4-6 hours), which should be billed as recovery room services.” Observation services should not be ordered by the physician for future, elective outpatient surgeries.
So i wanted to hear others opinion on this topic:
- can patients be in observation room without being in ER?
- should observation room be considered outpatient?
@Christian_Reich you and I worked on this about 5 years ago correct?