# Hospitalist saw Pt in the ER



## dentfam (Feb 4, 2009)

I have a question to see how you guys would code this situation.

Patient is listed in the hospital system as an emergency room patient. Patient stayed as such overnight.
Pt was not admitted to IP or listed as observation, just ER.

Our Hospitalist(not part of hospital) saw the patient and dictated a History and Physical.
Would you code it as an observation 99219 1st day and 99217 the 2nd day?
Or would you do 2 outpatient codes from 9920X-9921X?
Or would you just ignore the hospitalʼs listed status and code for an admission?
At the end of the H&P dictation it says admit patient to telemetry(observation).
HELP??
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## FTessaBartels (Feb 4, 2009)

*Observation*

I'd ignore what the hospital coded and code the service the physician provided. 

It seems clear that the hospitalist wanted the patient admitted for observation based on his/her  documentation, so I'd code the appropriate level observation for day one. 

I'm not sure from your note if the hospitalist SAW the patient on day 2. 
If s/he did, I'd code 99217 as per documentation. 

F Tessa Bartels, CPC, CEMC


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