UM Guidelines
Observation Goal Length of Stays

Inpatient and Surgical Care (ISC)

BCBST last reviewed August 31, 2021*

Changed:

Reference
ID

Guideline

BCBST
GLOS

S-22

Adrenalectomy by Laparoscopy

Observation

M-52

Angioplasty, Percutaneous Coronary Intervention

Observation

S-82

Ankle Dislocation, Closed or Open Reduction

Observation

S-100

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

Observation

S-131

Aortic Aneurysm, Abdominal, Endovascular Repair

Observation

P-12

Apparent Life-Threatening Event

Observation

S-185

Appendectomy, with Abscess or Peritonitis, by Laparoscopy

Observation

P-30

Appendectomy, with Abscess or Peritonitis, by Laparoscopy, Pediatric

Observation

S-170

Appendectomy, without Abscess or Peritonitis

Observation

P-25

Appendectomy, without Abscess or Peritonitis, Pediatric

Observation

S-200

Bladder Incision: Cystotomy

Observation

A-0167

Cardiac Pacemaker Implantation

Observation

S-292

Cardiac Valvotomy, Percutaneous

Observation

S-1330

Carotid Artery Stenting

Observation

S-300

Carotid Endarterectomy

Observation

S-320

Cervical Fusion, Anterior

Observation

S-340

Cervical Laminectomy

Observation

S-371

Cholecystectomy with Common Duct Exploration by Laparoscopy

Observation

S-400

Cranioplasty

Observation

A-0403

Deep Brain Stimulation (DBS)

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-490

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

Observation

P-505

Fundoplasty, Esophagogastric, by Laparoscopy, Pediatric

Observation

S-513

Gastric Restrictive Procedure with Gastric Bypass by Laparoscopy

Observation

S-515

Gastric Restrictive Procedure without Gastric Bypass by Laparoscopy

Observation

S-516

Gastric Restrictive Procedure, Sleeve Gastrectomy, by Laparoscopy

Observation

P-590

Hip: Congenital Dislocation, Open Reduction

Observation

S-632

Humerus Fracture, Closed or Open Reduction

Observation

S-660

Hysterectomy, Vaginal

Observation

S-665

Hysterectomy, Laparoscopic

Observation

S-710

Knee Arthrotomy

Observation

S-675

Knee Dislocation, Closed or Open Reduction

Observation

S-760

Knee: Fracture of Tibial Plateau, Closed or Open Reduction

Observation

S-450

Laparotomy for Gynecologic Surgery, Including Myomectomy, Oophorectomy, and Salpingectomy

Observation

M-333

Left Atrial Appendage Closure, Percutaneous

Observation

S-830

Lumbar Laminectomy

Observation

S-845

Lysis of Adhesions by Laparoscopy

Observation

A-0247

Mandibular Osteotomy

Observation

S-862

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

Observation

S-1000

Neck Dissection

Observation

P-357

Newborn Care, Routine

Observation

S-950

Patent Ductus Arteriosus, Open, Thoracoscopic, or Transcatheter Closure

Observation

P-950

Patent Ductus Arteriosus, Open, Thoracoscopic, or Transcatheter Closure, Pediatric

Observation

S-1310

Percutaneous Revascularization, Lower Extremity

Observation

S-960

Prostatectomy, Radical

Observation

P-370

Pyloromyotomy for Pyloric Stenosis

Observation

S-530

Removal of Posterior Spinal Instrumentation

Observation

S-634

Shoulder Arthroplasty

Observation

S-633

Shoulder Hemiarthroplasty

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-1124

Tibia/Fibula Shaft Fracture, Closed or Open Reduction

Observation

S-1132

Tibial Osteotomy, Adult

Observation

S-1131

Tibial Osteotomy, Child or Adolescent

Observation

S-1150

Ureterotomy, Nontransurethral for Stone

Observation

A-0287

Uterine Artery Embolization

Observation

A-0226

Vertebroplasty and Kyphoplasty

Observation

References

BlueCross BlueShield of Tennessee network physicians. January - April 2021.

 


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