Practice Management Alert

Question: A patient presented to our office with stomach pain and shortness of breath. Our physician subsequently rushed the patient to the hospital and admitted him for treatment of dehydration and asthma. Which POS is appropriate for this service?


Wisconsin Subscriber

Answer: If you report an inpatient care code, you must report the corresponding place of service (POS) code 21 (Inpatient hospital). The POS code on your claim should always be consistent with the site of service indicated in the codes you report. And you can't bill for both a hospital admission and an office visit on the same day because the initial inpatient care codes (99221-99223) that report hospital admission include all the physician's services on that date.

Therefore you should combine all the physician's work and documentation to determine the appropriate-level initial inpatient care code to cover the office visit, admission services and other inpatient treatment that day.