Wiki OB visit in the er

[kathleenl]

Morning,
Our OB oftens see's his patients in the ER, they are not kept overnight in observation, just in the ER and time goes by and it turns out that the patient is actually there overnight. He is asking us to bill for two er visits - one for the visit at 10pm and again at 7:30 am the next morning. This doesn't seem right to me....I am having a tough time finding out the correct way to handle these visits.

Any help is appreicated.

Thanks - Kathleen

 

[mcnaryk]

Morning,
Our OB oftens see's his patients in the ER, they are not kept overnight in observation, just in the ER and time goes by and it turns out that the patient is actually there overnight. He is asking us to bill for two er visits - one for the visit at 10pm and again at 7:30 am the next morning. This doesn't seem right to me....I am having a tough time finding out the correct way to handle these visits.

Any help is appreicated.

Thanks - Kathleen

Patients are staying less than 24 hours, and not being admitted as inpatients, so to me they ARE observation. Looking at CPT, for the initial visit at 10pm I would use a code from 99218-99220, then the observation discharge code 99217 for the 7:30am visit the next day. I could be wrong, I seem to remember something about visits less than 24 hours, but I can't find anything in CPT to say otherwise.

 

[hewitt]

This article may be of some help. http://www.todayshospitalist.com/index.php?b=articles_read&cnt=1437