In the ED, we do not technically have a separate location as of right now for pt's placed on Observation. The ED Physician just orders the pt be placed in ED obs, and they chart the initial/periodic/discharge review of the pt in ED obs.
From our understanding, on the first calendar day the pt comes in, when the pt is evaluated in the ED and placed in ED Obs, an initial obs code is used. i.e. 9922X
Then on the second calendar day, if the pt is still in ED Obs, but then admitted to Inpatient, a Subsequent Obs code is used. i.e. 9923X
So our issue is, if a pt is placed on ED Obs the first calendar day, the initial obs code is reported. i.e. 9922X
BUT, on the second calendar day, they're placed from ED Obs to Hospital Obs(completely separate dept. and providers), then wouldn't an E/M code be used for the second day? i.e. 9928X
From our understanding, on the first calendar day the pt comes in, when the pt is evaluated in the ED and placed in ED Obs, an initial obs code is used. i.e. 9922X
Then on the second calendar day, if the pt is still in ED Obs, but then admitted to Inpatient, a Subsequent Obs code is used. i.e. 9923X
So our issue is, if a pt is placed on ED Obs the first calendar day, the initial obs code is reported. i.e. 9922X
BUT, on the second calendar day, they're placed from ED Obs to Hospital Obs(completely separate dept. and providers), then wouldn't an E/M code be used for the second day? i.e. 9928X