Wiki Please HELP! 99234-99236

[ahonkomp]

If a patient came in thru the ER 8/25, was admitted to observation, the next day(8/26) was changed to Inpatient/Acute---The provider did an H&P and later within the same day did a discharge summary. Can I charge 99234-99236? Even though the encounter was started on 8/25.

Here is what is bothering me in CPT and CPT assistant:
"When a patient is admitted to the hospital from observation status on the same date, only the initial hospital care code should be reported"

My scenario doesn't exactly fit this but if the patient is observation status and then admitted and discharged all within the same date--Are they saying you can only bill the admit?

I get more confused the more I look into this and find many different answers on the appropriate use of 99234-99236.

I appreciate any guidance or references.

 

[Cynthia Hughes]

Per CPT, the service will be reported based on the dates of the physician's face-to-face services to the patient. If the physician first saw the patient on 08/26 and discharged the patient on 08/26 then same date admission and discharge codes are appropriate. (See end of article on subsequent observation and discharges services in CPT Assistant July 2012.) If the patient has Medicare, see Chapter 12 of the Medicare Claims Processing Manual for billing to Medicare as there are additional instructions regarding admissions of 8 hours or less.