Test Your Knowledge

What is the appropriate patient status?

A 70-year-old Medicare beneficiary presented via EMS with depressed mental status, hypoxia and ST segment elevations on EKG. 

1228: Vital signs upon arrival Temp 97, HR 120, RR 13, BP 86/67, oxygen saturation 93% on 4L/min 

1240: Initial labs demonstrated troponin 1.959 (H), K 5.9 (H), anion gap 23 (H), EKG sinus tachycardia, RBBB and acute anterior wall MI 

1247: IV Lasix, IV atropine, IV phenylephrine, IV Rocephin, IV Zithromax and cardiology consultation 

1300: Cardiac catheterization: stent deployed in the LAD to treat total occlusion of middle segment. Left ventriculogram: 25% ejection and large anterior, apical and inferior akinesis

1340: Patient transferred to ICU, IV Levophed initiated 

1403: Patient expired 

This case was sent to the Physician Advisor for recommendation on how to proceed with status/billing because the attending physician never entered a status order.

Poll: Should this patient be statused as Observation or Inpatient?

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