Second Medicare Compliance Determination

This is a second Medicare compliance determination. The initial compliance determination was made by EHR which felt the patient should be observation status. Dr. Neilian disagreed. My clinical review of the chart reveals that the patient is 89-years of age, she presented with shaking, chills, fever of 103 and hematuria. Her medical history is significant for a previous history of right breast cancer, chronic acquired lymphedema, as well as hypertension. Her initial labs showed her to have an elevated white blood count and left shift, as well as a positive blood culture growing E coli. I believe that this patient represents acute inpatient admission. She requires IV antibiotics so I concur with the attending physician Dr. Neilan who believes