Rules on patient signing out before work-up is completed

Can a symptom be assigned as a principal diagnosis if a patient signs out of the hospital against medical advice before work-up is completed?

re: RULES ON PATIENT SIGNING OUT BEFORE WORK-UP IS COMPLETED

The hospital UB should indicate discharge status 07 - Patient left AMA. The record should be detailed as to discussions with the patient/family about the risks of leaving prematurely, any and all personnel who discussed with patient, including patient responses & rationale about leaving and condition of patient when he/she left. Also should include why a definitive diagnosis is not possible based on timing when patient left. This is a potential liability/risk management issue that must clearly cover the hospital and managing physician. The managing physician's records should also include the above information. It is probable that the payer will request records to support reasons why a suitable diagnosis is not possible.