Wiki Billing for Inpatient when PT Admitted by another Provider

[BS&SC]

I ran into a problem billing a Medicaid patient who was not admitted by our providers and whose labor was three days before actual delivery. For that first day, I can bill, correct? If so, I see that CPT suggests Inpatient Consultation codes when the provider isn't the admitting, but these feel wrong too because our providers see the patient pretty soon after they are admitted, then everyday after and aren't returning care to another doctor. My fellow coder doesn't understand why the hospital doesn't have her as Observation until delivery. All I know is that it describes her as “inpatient” in the Cerner note. Do I still use the 99251 codes to bill for that first day before the 24 hour window of her delivery?

Please educate me.

 

[nielynco]

I ran into a problem billing a Medicaid patient who was not admitted by our providers and whose labor was three days before actual delivery. For that first day, I can bill, correct? If so, I see that CPT suggests Inpatient Consultation codes when the provider isn't the admitting, but these feel wrong too because our providers see the patient pretty soon after they are admitted, then everyday after and aren't returning care to another doctor. My fellow coder doesn't understand why the hospital doesn't have her as Observation until delivery. All I know is that it describes her as “inpatient” in the Cerner note. Do I still use the 99251 codes to bill for that first day before the 24 hour window of her delivery?

Please educate me.

This is definitely not a consultation coding scenario. The patient presents and is admitted so you bill the hospital admission code by the admitting MD and then any subsequent visits up to 24 hours prior to delivery by whichever MD provided that care.