Orthopedic Coding Alert

Question:When our orthopedist admits a patient to the hospital after-hours from the emergency department (ED), which codes should I report?Arkansas SubscriberAnswer:If the orthopedist performs the ED visit and admission on the same date, you should combine all services that the physician performs and documents into one admission code (99221-99223, Initial hospital care, per day ...). CPT considers all E/M services that a physician provides on the same date in another site of service part of the initial hospital care. So when your orthopedist performs same-day outpatient and inpatient services, you should include the ED work in the initial hospital care level.Watch out: If the physician performs services on different service dates, you should bill each service. For example, the orthopedist treats an ED patient at 11:45 p.m. and admits the patient after midnight. Because the services occur on different dates, you should bill both the ED service and the admission. [...]