Observation/subsequent/initial coding

[Anna Weaver]

Can anyone help me please? We are trying to figure out the observation, subsequent, and initial coding. When a patient is admitted as an observation patient, the physician charges the initial observation charge. The next day the patient is admitted as an inpatient, should the charge be a subsequent visit or should it be an initial inpatient? I have had conflicting information. One states should be initial, however, I have been told that there should only be one initial visit per hospital stay. The more I read the CPT book, the more confused I become. I finally had to set it aside for awhile, and thought I would try this. All help appreciated. Any resources? Thanks
Anna Weaver, CPC

[rammon]

Anna-
If you read in your CPT book under Initial Observation Care, second paragraph, it states "For a patient admitted to the hospital on a date subsequent to the date of observation status, the hospital admission would be reported with the appropriate Initial Hospital Care code (99221-99223). Page 11 in the CPT 2008 Professional Edition --bottom of first column

Hope this helps clear it up for you.

Robby Ammon, CCS-P, CMC, CPC