OV - Admit question

[resak]

Here's my scenario-

Patient presents to the office. MD assesses the patient (would have been a 99214) and decides to admit the patient to the hospital. MD writes the admit orders, and dictates the the hospital H&P. The patient goes to the hospital after the office encounter, however physician DOES NOT see the patient in the hospital setting until the following day.

MD wants to bill an admit on the date of the office encounter, and follow up hospital visit on day 2.

Can someone please offer their thoughts on this, and direct me to the appropriate resource on how this is done properly?

Thank you for your time.

[dphillips]

Your MD is correct. Since he did see the patient in his office, the admit was essentially done from his office. He has 24 hours to dictate the HPI for the admit. So he can bill the admit but not the OV and he can bill the subsequent visit the next day.

Dawn CPC, CCC

[cheermom68]

I would have to disagree. 99221-99223 are initial hospital encounters. You cannot bill these codes unless the patient is seen in the hospital on that date of service. I would bill the office visit for that date of service and then would bill the initial hospital visit the next day (if documentation meets criteria) when he sees the patient face to face in the hospital for the first time. If he were to have seen the patient in the hospital on the first day, then all services including the office visit would be rolled into the "admit" and billed as one code.
LeeAnn

[sdelmas]

I agree with LeeAnn. If the physician saw the patient only in the office the first day, but didn't come to the hospital till the next day, he/she can bill for an admit only on the day the patient was actually seen in the hospital. So in your case the first day should be one of the codes 99212-99215. And if notes support the requirements he/she can bill for 99221-99223 the next day.

Sofia, MS, CPC