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Admission codes with emergency room place of service

slsommer

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Ackworth, IA
How should this scenario be coded: Patient is in the emergency room and an order is placed for an inpatient bed admission (or observation bed admission) but the patient remains in the emergency room for that admission stay. The hospital leaves the patient's place of service as the emergency room and the hospitalists are billing the inpatient cpt codes (i.e., 99221-99223, 99231-99233, 99238). So the patient is basically 'boarding' in the ER. Would it be accurate to bill the inpatient cpt codes when the patient remains in the emergency room?
 
In the notes does it read where the provider seen him. If it was at the patient's bedside or if the patient was just release to go home it is okay to bill the POS 23 but I would check with the payer sometimes to see if the initial is covered
 
I run into the same issue. The patient stays in the ED but was admitted. I have providers do a H&P and discharge, but I get flagged because POS 23 can't have those codes (99221-99223 or 99238-99239). How do I code? Do I change the H&P to ED codes, 99283-99285?
 
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