becka95
Networker
Ok, we have another ongoing argument here about admissions. Based on what I remember, E&M codes are based on where the pt ended up not always where they were seen. So if the patient was seen in the ER as a consult and another Dr admitted you would use the inpatient code for the consult.
But….. What if the patient was seen in the ER as a trauma at 11pm but the admission orders are not written until after midnight and the H&P isn't dictated until after midnight, what date would you do the admit code? I understand that for some patients it can take a while to stabilize them before they transfer them to the unit. The doctors are arguing that if the patient is admitted in the wee hours, they are losing a day for rounds because the pt is still rounded on later that day. Also, due to the patient's condition, sometimes the doctor may not get a chance to write his notes until after midnight.
I think that we should bill a prolonged but not all insurances cover the prolonged care. And if the patient doesn't meet Critical Care guidelines, I can't use that.
But….. What if the patient was seen in the ER as a trauma at 11pm but the admission orders are not written until after midnight and the H&P isn't dictated until after midnight, what date would you do the admit code? I understand that for some patients it can take a while to stabilize them before they transfer them to the unit. The doctors are arguing that if the patient is admitted in the wee hours, they are losing a day for rounds because the pt is still rounded on later that day. Also, due to the patient's condition, sometimes the doctor may not get a chance to write his notes until after midnight.
I think that we should bill a prolonged but not all insurances cover the prolonged care. And if the patient doesn't meet Critical Care guidelines, I can't use that.