Wiki Admission Question

[jtb57chevy]

We are having a friendly discussion in our office and need some outside guidance.

Scenario: Patient is brought to ED late in the evening w/chest pain and after evaluation by cardiologist, is taken for emergent heart cath. Next morning the cardiologist documents the H&P admission note and also rounds on the patient. So in the EHR there is an admission note dated day 2 (although the content was obtained on day 1) and a progress note on day 2.

Is it correct to bill for the admission on day 1 or is it billed on day 2, which is the day after the procedure, or is it not billed at all?

Any reference documents will also be greatly appreciated......

 

[theresa.dix@tennova.com]

We are having a friendly discussion in our office and need some outside guidance.

Scenario: Patient is brought to ED late in the evening w/chest pain and after evaluation by cardiologist, is taken for emergent heart cath. Next morning the cardiologist documents the H&P admission note and also rounds on the patient. So in the EHR there is an admission note dated day 2 (although the content was obtained on day 1) and a progress note on day 2.

Is it correct to bill for the admission on day 1 or is it billed on day 2, which is the day after the procedure, or is it not billed at all?

Any reference documents will also be greatly appreciated......

You need to bill the h&p on the date that the face to face encounter occurred( same day as cath) and the subsequent visit on the date the face to face encounter occurred(day after cath).You can bill both. Maybe a correction should be made to the progress note.