Pediatric Coding Alert

Question: How should I bill for a patient admitted by telephone and discharged the next day?

Washington Subscriber

 
Answer: This often happens when a child goes to the emergency department (ED) and the ED physician calls the pediatrician. The pediatrician cannot bill for the date of admission because a hospital admission must be face-to-face. The ED physician should perform the admission. When the pediatrician visits the patient the next day, he or she bills a same-day admission and discharge (99234-99236).
 
Bill only for the days when the physician sees the patient. The work done on the telephone is not a billable service on that date. Bill the admission/discharge code (99234-99236) on day two if the patient is discharged that day. If not discharged, bill the admission (99221-99223) that day and the discharge (99238) the day the patient leaves.
 
The admission day will be different from the hospital admission day; that does not present a problem. Put the date of admission on the HCFA form to match the hospital's date of admission. But bill the admission CPT code based on the date the physician first saw the patient in the hospital.