Question: I have trouble figuring out how to charge for a patient that was in observation, then admitted to the hospital, and then discharged. How would I report: observation on 8/20/11, admitted 8/21/11, and discharged 8/22/11? Also, how do I list place of service -- in-patient or observation?
North Dakota Subscriber
Answer: If an observation patient is admitted to inpatient status by the same practitioner on a subsequent day, you may bill as follows, according to Maggie M. Mac, CPC, CEMC, CHC, CMM, ICCE, director, Best Practices-Network Operations at Mount Sinai Hospital in New York City:
Remember: CPT® does not include a code for hospital admission itself. You'll bill 99221-99223 for the admitting physician for the physician's care if he documents the elements contained within the codes (appropriate history, exam, and medical decision-making). You are not billing for the admit itself, but rather billing for the care that your physician provides based on the documentation.