This is from CMS -
30.6.9.1 -
A. Initial Hospital Care From Emergency Room
Contractors pay for an initial hospital care service or an initial inpatient consultation if a physician sees his/her patient in the emergency room and decides to admit the person to the hospital. They do not pay for both E/M services. Also, they do not pay for an emergency department visit by the same physician on the same date of service. When the patient is admitted to the hospital via another site of service (e.g., hospital emergency department, physician's office, nursing facility), all services provided by the physician in conjunction with that admission are considered part of the initial hospital care when performed on the same date as the admission.
B. Initial Hospital Care on Day Following Visit
Contractors pay both visits if a patient is seen in the office on one date and admitted to the hospital on the next date, even if fewer than 24 hours has elapsed between the visit and the admission.
So, he can follow scenario A above and bill the 99221 if he prefers and the place of service would be the hospital. Or, if he does a more extensive visit with the patient the following day in the hospital, he could bill an office visit for the day of the admit and his initial hospital visit the next day (per scenario B). When admitted straight from the office, I usually bill the initial hospital visit.
Lisi, CPC