# Observation discharge 99217 and admission to the hospital



## bas0229 (Nov 18, 2014)

Our ER doctor billed an initial observation code (99220) and the following day the patient was discharged from observation care in the AM and admitted to an inpatient status in the PM.  Our doctor billed the discharge visit 99217 since it was a separate day.  Another specialist (in this case a cardiologist) admits the patient on the same day as the discharge visit 99217.  Medicare denied the claim indicating that 99217 "is not paid separately when the patient is inpatient".  I have done a lot of research and I cannot find the exact answer to this.  Can the ER doctor bill for the discharge 99217 if the patient is admitted on the same day even if it's by a different specialty?  If not, what would the ER physician bill?  Would he/she have to bill a subsequent hospital visit?  Thanks for any advise anyone can provide!


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## sivagurulingam (Nov 30, 2014)

We can bill,99217 for the ED physician and initial hospital visit to another specialty provider on the same day. Please re appeal the claim with clear note like the patient discharged by ED provider for the reason in the AM and cardiologist admit in the PM because both service rendered by different specialty provider. If both service rendered by the same specialty provider that time the initial hospital visit need to bill with subsequent visit.


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