Wiki ED injections/infusions admitted patients

[pamtc2000]

I need clarification as to whether or not injections and/or infusions in the ED are coded and billed on the inpatient bill (UB-04) when the patient is admitted as a inpatient (not observation). I have been told that they are not, since Medicare pays inpatient claims by the DRG.

 

[jimbo1231]

Mostly

There are a couple of interpertations of this one. Since these services are provided within three days of the admit they are usually bundled into the inpatient DRG for Medicare. This is a Medicare rule so not every payer must follow it, although most do. There has been an approach for a year or two that if the Ed vist and admit are unrelated based on diagnosis, these outpatient services can be billed separately. However per the same legislation that increased physician fees, Medicare won't pay for these services separately if the patient is admitted.