Gastroenterology Coding Alert

Question: When we admit a patient to the hospital directly from the office, should we bill just the office visit or both the office visit and the hospital admission?

Florida Subscriber

Answer: Usually when you admit a patient to the hospital, you should roll everything your physician performed that day into the admission code.
 
You can't bill a separate hospital admission and a separate office E/M service on the same day unless you meet certain criteria. If the gastroenterologist renders a consultation in the office on Thursday and decides he should admit the patient to the hospital - he writes orders, sends in the orders, a history and a physical - he may report the in-office consultation code only if the patient is not seen in the hospital face-to-face that day. If on the following day, Friday, the gastroenterologist performs the initial hospital visit, you should report the office consultation performed on Thursday as well as Friday's initial hospital care (99221 to 99223).