# Help!!! Admit and Discharge on Same day?



## j.kruetzkamp (Aug 22, 2013)

I need some help.  I have a physician that I am auditing that has really confused me.  I am auditing his inpatient level 3's.  I will start from the begining.  The phsycian billed a 99223 on 08/14/13 and a discharge on 08/15/13. So, I go into the chart to look at the the documentation.  The patient was seen in the ED on 08/13/13.  Around 11:50-12:00 the patient was admited to observation (not inpatient).  So, on 08/14/13 the patient is in observation.  According to what I find in the patients chart with the nursing notes and what the physician documented, the physician did see the patient until 08/15/13.  When he saw the patient he then decided to discharge the patient.  The physician's notes are for an H&P/Discharge dated 08/15/13.  

So my question is....Can the physician bill an admit on 08/14/13 and a discharge on 08/15/13.  Or can he bill an admit and discharge on same day for 08/15/13. Or can he only bill the initial on 08/15/13 and no discharge?  Keep in mind that he origianlly billed inpatient but the patient is in observation.

Thanks,


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## jettman (Aug 22, 2013)

Hello. Keep in mind that in order to report an E/M service, the provider must have a face-to-face encounter with the patient on the date he or she wishes to report.  I gather from your post that your patient was in observation status on 8/15? If the provider documented face-to-face H&P and discharge services on that date, the appropriate code to report would be from the 99234-99326 series of codes, Obs or Inpatient hospital care, including admission and discharge on the same date. 

Hope this helps!


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