View source for Harbor:Interqual Override Notes

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