2016-41: 30-Hour Observation Rule

Date: 08/25/16

Effective September 1, 2016, we will begin enforcing the Louisiana Department of Health's 30-hour observation rule, based on the Louisiana Hospital Services Provider Manual.

When applicable, hospitals should bill for treatment or observation room charges with the appropriate covered revenue codes. The entire outpatient visit, including observation, may not exceed 30 hours duration (Louisiana Hospital Services Provider Manual Section 25.3, page 19).

Any request for observation hospital visit greater than 30 hours that does not convert into an acute inpatient hospital admission will result in an administrative denial. Be advised that administrative denials cannot be appealed.