Wiki Hospital Billing Confusion..please help?

[KArmstrong86]

My doctors at my clinic take turns doing rounds at our local hospital. These are the scenarios that I am confused about if anyone can help answer I really need to pick someone's brain.

1) pt arrives in ER and our doctor ends up seeing them that day and decides to admit(date 6/18). the hospital has their admit date on everything as 6/19(the date they got to med surg floor). Do will bill the H+P on 6/18 or 6/19?

2) pt comes in late night and a NP seeing them but the doctor doesn't round on the pt til the next morning and they are released that day. Do/Can we bill a 99235 or do we just have to bill either and admit or a discharge and lose out on the other?

3) if one of our doctors admits 6/1 and the other discharges 6/2 but less than 24 hours, do we bill and H+P 6/1, D/C 6/2? both are in the same group/tax id number

If anyone can help or has an email/contact info, I could REALLY use the help. I just don't want to mess anything up and bill incorrectly. Thank you!

 

[Pam Warren]

Here's the most helpful thing I can share. If services happen on consecutive, different days, you usually can bill both.
1. Bill the doc's ED visit on the date of the face to face serivce (6/18). The facility admission is when the order to admit is placed, which sometimes doesn't get entered until the next calendar day.
2. NP can bill for their service on that evening, and the MD can bill for the next day's round if it's docmented as a round, but if he also documented a discharge note, bill the discharge only. Two different calendar days, you can bill both. The admit/dc combo code is reported if both happen on the same calendar day, so that doesn't apply at all to this scenario.
3. Admit/dc same day less than 24 hours is irrelevant if they're admitted and discharged on consecutive days. Bill the initial inpatient charge for 6/1 and the discharge on 6/2.