Wiki ER PATIENT SWITICHING TO INPT

[kanderson381@gmail.com]

Hello,
If a patient is in the ER and a EKG is rendered while in the ER, if the patient was switched to inpatient does that mean that you will bill the EKG as Inpatient?

I have another scenario if a patient is in the ER and a hospitalist come into the ER and see the patient does the hospitalist get to bill for his services?

 

[Pam Warren]

For professional services only, you bill the POS that the patient was in at the time of the face to face encounter. So, if you're billing for the EKG read by the ED provider, you'd bill POS 23, Emergency Department, unless the admission orders had already been placed. This is correct coding, but some payers don't seem to understand that part. I always advocate for correct coding, though.
The answer to your second question is yes. The hospitalist can consult in the ED and may decide to admit under his service.
It's when billing the facility charge that everything rolls up to the admitting status from the time the patient presents. For pro-fee you bill the POS at the time, and the order to admit drives the switch to a different POS.

 

[lawalls27]

I have trouble w/this, too. I constantly have payers denying an ER visit, for POS, but when I check hosp access for the times that procedure was performed vs the time they were admitted, 9.99 % of the time it is coded correctly as ER.