Wiki Obs Billing - Coding Question


Local Chapter Officer
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I work for a PCP in a private office... he does have privileges at the hospital next door. My question is we had a patient seen on 5/11/17 @ 19:45 that he was called on and he ordered the admit to obs... however he did not see the patient until 5/12/17 AM then discharged the patient on 5/12/17 @ 16:05. It's under the 24 hr obs mark.... SO my question is do I bill this with a 99234 or as a 5/11 - 99218 and 5/12 - 99217 ?
Thank you in advance for your help!
The observation or inpatient status begins at the time the order is written, so CPT code 99234 would not be appropriate since in this case the patient was not admitted and discharged on the same date.

The CMS guidelines state that "When the patient is admitted to the hospital via another site of service (e.g., hospital emergency department, physician’s office, nursing facility), all services provided by the physician in conjunction with that admission are considered part of the initial hospital care when performed on the same date as the admission", so the services performed in the PCP's office on 5/11 would be considered part of the initial observation care on that date.
Okay I'm sorry the patient reported to the ER on 5/11/17 and the ER Doc called our doctor and he submitted a verbal order. Thats why/what I'm asking.