# ER with subsequent inpt admit



## staceylh (Sep 7, 2012)

Patient seen in ER 9/2 (discharged early 9/3) and then admitted to the same hospital on 9/6.  According to Medicare 72 hour rule, should the two accounts be combined.  OR do we use the admit dates, in which case it's over 72 hours and would not be combined?


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## jimbo1231 (Sep 8, 2012)

*Facility or Physician?*

Are you asking about facility or physician coding? On the physician side, the 72 hour rule doesn't apply. On the facility side was the reason for the hospitalization clearly related to the ED visit? If the patient visited the ED for an ankle sparain is admitted for an MI, they are not related and you can bill for both.
I believe if the bulk of services were on 9/2, you are also OK since the three days would be 3,4 and 5. But I would defer to others on this one.

jim


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## kjb20070@yahoo.com (Sep 8, 2012)

I would agree with Jim above. For the physician side the 72 hr rule doesn't apply. For the facility it will depend on the reasons for the Er visit and the admit


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## staceylh (Sep 10, 2012)

Our facility rolls everything to the inpatient, regardless of the reason for visit/diagnosis.  My understanding is that we base the need to combine on the admit dates for each visit.  If the patient was brought to the ER on 9/2, then the 9/6 admit to inpatient would be greater than 72 hours.


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## staceylh (Sep 10, 2012)

Thanks Jim, that's my understanding as well.  We're having a dispute with patient accounting on this one.  They're combining based on the ER discharge of 9/3.


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