Ok - feeling pretty stupid here. I have a patient who was seen in the ED on 8/7 very late at night (ED doc around 9:30pm); then my doc (peds) came in around 11:00pm and at some point wrote to admit the patient. The patient did not go to the floor until after 1:00am on 8/8/08, so according to the hospital he was not an inpatient until 8/8. My doc then saw the patient again on 8/8 as an inpatient (pt does not go home until 8/10). My confusion? He did all the admit work on 8/7 and then did f/u on 8/8 but the admit date per the hospital is 8/8. According to CPT "all e/m services provided in conjunction with the admission are considered part of the initial hospital care when performed on the same date as the admission." So what do I do with his "admit" order for 8/7 and his hospital f/u for 8/8? Can I charge an outpatient visit for 8/7 and the initial hospital for 8/8 even though in his mind the patient was admitted on 8/7 not 8/8?