# Observation same day admit/discharge but two different physicians



## grepay (May 21, 2017)

I have a patient who came into the ED and was admitted to observation by a physician. Later but same day, another physician (same specialty) discharged the patient. How should this be coded?
99218 to the admitting physician and nothing to the discharging physician?
99234 to one but not both of the physicians?

How would this play out if the physicians were two separate specialties?

Thanks,
Gerrie


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## Kris Cuddy (May 22, 2017)

Were the two physicians of the same specialty in the same group? If so, you'll have to bill as if they were one physician providing the service.

For Medicare, if it had been two separate specialties, only the admitting provider can bill initial or discharge E/M codes, so the second provider would have to bill Office or Other Outpatient Services E/M codes based on their documentation and whether the patient is new or established to the provider or the provider's group.


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## grepay (May 22, 2017)

Yes, same specialty group. I gave the admitting physician 99218. I didn't bill the service for the second physician.


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