Inpatient vs Outpatient Surgery – What is the Difference?

Having to have any kind of surgery can be nerve-wracking, but it is important to understand the difference between inpatient and outpatient surgery.

When Does it Count as Inpatient Surgery?

You are an inpatient when you are admitted to the hospital and assigned to a room. You have to be formally admitted by your doctor for it to count.

This is not the same thing as being told to go to a hospital to get more tests or going to the emergency room. The doctor will give specific instructions for your care (they must have admitting privileges at the hospital).

You stay an inpatient until the day before you are discharged.

If I Have to Stay Overnight, Can it Still be Outpatient Surgery?

If you have not been admitted, then you are still an outpatient even if you end up spending the night at the hospital.

For example, if you come into the ER and don’t actually get treated until the following day, you are still an outpatient.

It’s not uncommon for a series of tests to take long enough that you will spend the night there, or to spend the night after a surgery that is scheduled for late in the day.

What if I’m Under Observation?

If the doctor keeps you under observation after the surgery, then he is still deciding whether you need to be an inpatient. You may be put under observation after surgery for a period of time so the doctor can ensure there are no complications. You are still not an inpatient until and unless you are formally admitted, again, even if you spend the night in the hospital.

It’s important to know whether you are an inpatient or an outpatient so you can make the appropriate claims from your insurance company. It affects your costs, especially if you are on Medicare.