obs status changed to inpt in hosp for 4 days

rdmeese

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Plattsburgh, NY
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patient is in obs, changed to inpt day 2 , stays day 3 & 4
our charges team enters the charges that way day 1=obs , day 2= inpt day 3=inpt , day 4 =inpt
Can they bill that to medicare?
 

emcee101

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E/M Code Families

If/When an observation stay is converted to an inpatient stay, the admission date should be changed back to the patient's first day in the hospital. Therefore, day 1 should be your inpatient admission code, and days 2-4 should be your subsequent hospital care codes.
 

bedforak1

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If/When an observation stay is converted to an inpatient stay, the admission date should be changed back to the patient's first day in the hospital. Therefore, day 1 should be your inpatient admission code, and days 2-4 should be your subsequent hospital care codes.
I disagree. I too thought that was the correct way, but after extensive research, there are many factors to consider. You could bill day 1 as the initial observation code and days 2-4 should be subsequent inpatient codes. I would also check with your MAC for specific guidelines. Here's a link from CMS too that I found very helpful.

https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/downloads/R1875CP.pdf
 
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