UM Guidelines
Ambulatory or 1 day Goal Length of Stay

Inpatient and Surgical Care (ISC)

BCBST modification effective June 18, 2014*

Changed:
   
The following Goal Length of Stays have been modified to Observation.
 

ORG

Guideline

BCBST Modified GLOS

S-22

Adrenalectomy by Laparoscopy

Observation

S-82

Ankle Dislocation, Closed or Open Reduction

Observation

S-100

Ankle Fracture, Closed, Open Reduction, Internal Fixation (ORIF)

Observation

S-152

Aortic Coarctation, Angioplasty

Observation

P-12

Apnea, Apparent Life-Threatening Event

Observation

P-20

Appendectomy, Uncomplicated , Open or Laparoscopic

Observation

S-170

Appendectomy, without Peritonitis

Observation

S-175

Appendectomy, without Peritonitis, by Laparoscopy

Observation

S-200

Bladder Incision: Cystotomy

Observation

S-282

Cardiac Septal Defect: Atrial, Transcatheter Closure

Observation

S-292

Cardiac Valvotomy, Percutaneous

Observation

S-320

Cervical Fusion, Anterior

Observation

S-371

Cholecystectomy with Common Duct Exploration by Laparoscopy

Observation

S-420

Elbow Arthroplasty

Observation

S-424

Elbow Fracture, Open Treatment

Observation

M-157

Electrophysiologic Study and Implantable Cardioverter-Defibrillator (ICD) Insertion, Transvenous

Observation

S-445

Esophageal Diverticulectomy, Endoscopic Stapling

Observation

S-490

Foot Fracture, Calcaneus or Talus, Open Reduction, Internal Fixation (ORIF)

Observation

S-1305

Hernia Repair (Non-Hiatal)

Observation

S-632

Humerus Fracture, Closed or Open Reduction

Observation

S-675

Knee Dislocation, Closed or Open Reduction

Observation

S-810

Lumbar Diskectomy, Foraminotomy, or Laminotomy

Observation

S-830

Lumbar Laminectomy

Observation

S-845

Lysis of Adhesions by Laparoscopy

Observation

S-862

Mastectomy, Complete, with Insertion of Breast Prosthesis or Tissue Expander

Observation

S-1000

Neck Dissection

Observation

S-950

Patent Ductus Arteriosus, Open, Thoracoscopic, or Transcatheter Closure

Observation

S-1310

Percutaneous Revascularization, Lower Extremity

Observation

S-970

Prostatectomy, Transurethral Resection (TURP)

Observation

S-1020

Repair of Pelvic Organ Prolapse

Observation

P-443

Slipped Upper Femoral Epiphysis, Closed Reduction

Observation

S-1062

Splenectomy by Laparoscopy

Observation

S-1072

Sympathectomy by Thoracoscopy or Laparoscopy

Observation

S-1082

Thoracotomy with Biopsy or Miscellaneous Procedures by Video-Assisted Thoracic Surgery (VATS)

Observation

S-1132

Tibial Osteotomy, Adult

Observation

S-850

Urethral Suspension Procedures

Observation

References

BlueCross BlueShield of Tennessee network physicians. April - June 2014.