Wiki Inpatient/Outpatient billing

[sdb67]

I have a provider who is billing for outpatient services while patient is currently in the hospital. This is a cancer patient who came in through the ER and the next day they billed for 77334 with POS 22. would this be appropriate?
thanks for any input

 

[lilleyea]

It depends on the status of the patient. Patients can be in the hospital admitted to either inpatient status (POS 21), observation status (POS 22), or they can remain in the ER (POS 23). So you would have to see what the status of the patient was during that time.

 

[sdb67]

The patient was inpatient with a LOC 21 and then the next day we received charges for LOC 22 charges. I know CMS has the Three day Payment Window Policy, just wasn't sure that this would fall into that category. thank you!