# outpatient or inpatient



## peeya (Nov 2, 2011)

Patient was scheduled for an outpatient angiogram. But after the angiogram it was decided that he needed a bypass the same day. How do I bill the angiogram, as an out patient or inpatient.  

The patient got admitted right away.

Please advise.


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## TonyaMichelle (Nov 2, 2011)

*Outpatient or Inpatient?*

In the Cpt codebook under, " Initial Hospital Care, New or Established Patient" it states :

When the patient is admitted to the hospital as an inpatient in the course of an encounter in another site of service (eg. hospital emergency department, observation status in a hospital, physician's office, nursing facility) all evaluation and management services provided by that physician in conjunction with that admission are considered part of the initial hospital care when performed on the same date as the admission. The inpatient care level of service reported by the admitting physician should include the service related to the admission he/she provided in the other sites of service as well as in the inpatient setting.

Hope this helps.


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## peeya (Nov 3, 2011)

TonyaMichelle said:


> In the Cpt codebook under, " Initial Hospital Care, New or Established Patient" it states :
> 
> When the patient is admitted to the hospital as an inpatient in the course of an encounter in another site of service (eg. hospital emergency department, observation status in a hospital, physician's office, nursing facility) all evaluation and management services provided by that physician in conjunction with that admission are considered part of the initial hospital care when performed on the same date as the admission. The inpatient care level of service reported by the admitting physician should include the service related to the admission he/she provided in the other sites of service as well as in the inpatient setting.
> 
> Hope this helps.



The above is applicable when its an e/m code. But my question was regarding the place of service for the angoigram/cath, should it be outpatient or inpatient.


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## Jim Pawloski (Nov 3, 2011)

peeya said:


> The above is applicable when its an e/m code. But my question was regarding the place of service for the angoigram/cath, should it be outpatient or inpatient.



I would bill it as an outpatient.  The procedure findings cause the patient to go from outpatient to inpatient


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## dpeoples (Nov 3, 2011)

Jim Pawloski said:


> I would bill it as an outpatient.  The procedure findings cause the patient to go from outpatient to inpatient



I agree with Jim. Angio is outpatient, bypass is inpatient.

HTH


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