Wiki Hospitalist e/m obs


Spring Valley, IL
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Having frustrations with determining the e/m level for a hospitalist on an obs visit.

I suppose the confusion lies within the DOS versus when the patient was seen by the hospitalist and when he dictated.

Example: date of service 5/6/15 to 5/7/15 but the provider only saw the patient on 5/7. He dictated an H&P and a Discharge Summary on 5/7/15.

What should the charge be, 99218 only? or 99234?

He was admitted to obs 5/6/15 by the ED phy, then was not seen until 5/7/15. So his length of stay is 5/6/15 to 5/7/15, but the dr saw him and dictated 5/7/15.

Please clarify, Thank You
The DOS is what you go by as that's when the patient was seen. Since this is on the discharge day, all E/M services would get billed as Obs Discharge 99217, as long at the patient is discharged out of the hospital and not discharged from obs to inpatient.