# Office visit vs. Hospital admit? - doing this correctly



## heathergirl (Mar 12, 2008)

We have a patient that has been seen in the office today and had an EKG. The Dr will not be seeing her in the hospital till tommorow. I have been coding these as office visits, because the Dr does not go in to see the patient till next day. She said she wanted to do her Admit today. Not sure how to handle this or if I have been doing this correctly. Please help. 
Can she write up her admit today or does it have to  been done tommorow?
Heather D Unklesbay, CPC,MA


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## LOVE2CODE (Mar 12, 2008)

Would you clarify your question a little more?..

I am getting that pt came in office today and was admitted today?
If so, you can bill for office visit & ekg if your Doc is not the admitting Doc....
If your Doc is the admitting Doc, you can not bill for office visit but you can bill for an Initial Hosp (9922-).

Hope this info helps....


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## rthames052006 (Mar 12, 2008)

It would be nice to have a little more clarification.

I know that the h&P must be done within 24 hours of the actually admission.

Will your doc be going to see pt tomorrow, if so he/she should bill for the H&P when it is actually done.


Roxanne Thames, CPC






heathergirl said:


> We have a patient that has been seen in the office today and had an EKG. The Dr will not be seeing her in the hospital till tommorow. I have been coding these as office visits, because the Dr does not go in to see the patient till next day. She said she wanted to do her Admit today. Not sure how to handle this or if I have been doing this correctly. Please help.
> Can she write up her admit today or does it have to  been done tommorow?
> Heather D Unklesbay, CPC,MA


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## heathergirl (Mar 12, 2008)

*Clarification*

Sorry- after I re-read my post I realized that it was not very clear.  Patient was seen today in the office and had an EKG.  The Dr decided that she needed to be admitted during the office visit, but she would not see her in the hospital untill the tommorow.  She wanted to go ahead and fill out her admit papers online with the hospital, so she would not have to do it in the morning.  I was thinking that because we did not actually perform a service in the hospital I could not bill POS 21.  I hope this make since


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## rthames052006 (Apr 29, 2008)

heathergirl said:


> Sorry- after I re-read my post I realized that it was not very clear.  Patient was seen today in the office and had an EKG.  The Dr decided that she needed to be admitted during the office visit, but she would not see her in the hospital untill the tommorow.  She wanted to go ahead and fill out her admit papers online with the hospital, so she would not have to do it in the morning.  I was thinking that because we did not actually perform a service in the hospital I could not bill POS 21.  I hope this make since



In that case I'd bill for the office visit, when your MD goes to the hospital to see the pt for the 1st time bill the H&P on the day it is done.


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## LOVE2CODE (Apr 30, 2008)

rthames052006 said:


> In that case I'd bill for the office visit, when your MD goes to the hospital to see the pt for the 1st time bill the H&P on the day it is done.




I agree w/rthames052006.....


YTH,CPC


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## McNana (Oct 15, 2008)

Coding & Documentation

Cindy Hughes, CPC

Hospital admission following an office visit

Q When a physician sees a Medicare patient in the office and, in the course of the office visit, determines that hospital admission is required, how should this be coded? Is it necessary to visit the patient again in the hospital after having seen him or her in the office, or is the time spent with the patient in the office sufficient to fulfill the requirements for the admission code?

A To submit an inpatient care code, you have to see the patient in the hospital. If you provide the office visit and see the patient in the hospital later that day, you'll be paid only for the inpatient care code, because Medicare states that "All services provided by the physician in conjunction with that admission are considered part of the initial hospital care when performed on the same date as the admission." If you don't see the patient in the hospital until the next date, you will be paid for both the evaluation and management visit and the inpatient care, because Medicare also states that "Carriers pay both visits if a patient is seen in the office on one date and admitted to the hospital on the next date, even if fewer than 24 hours has elapsed between the visit and the admission."


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