Wiki Inpatient discharge outpatient admit same day

[treinemer]

I code for Hospitalists and have a patient that was inpatient hospital from 2/16-2/17 and discharged on the 17th for a cardiac condition. On the way home he was in a MVA and was taken back to the hospital later in the day and admitted outpatient observation.

In researching this I found if it was for the same condition I would just convert the code to a sub visit, but because the second admit was for a different condition I should be able to code with the outpatient admit code.

Is there a modifier I should use? This is a Medicare patient and the only thing I found was a Condition Code B4 but I think this is for hospital billing only. Is there any modifiers I can/should use?

Thanks!

 

[jimbo1231]

Observation Codes

You are right about different diagnoses allowing separate CPTS. But if the second admission, I'm assuming through the ED,was to Observation I would think you would use the Observation codes for the second stay. And the correct codes would be determined by whether second stay was a one day (99234-6) or or multiple days. Unless I'm missing something like the patient was admitted to the hosital through Observation?

Jim

 

[treinemer]

You are right about different diagnoses allowing separate CPTS. But if the second admission, I'm assuming through the ED,was to Observation I would think you would use the Observation codes for the second stay. And the correct codes would be determined by whether second stay was a one day (99234-6) or or multiple days. Unless I'm missing something like the patient was admitted to the hosital through Observation?

Jim

Thanks Jim! He was re-admitted through the ER for observation due to altered mental status (initial inpatient visit was for cardiac). The second visit would probably even go through the vehicle insurance anyway.

Thanks!!