Wiki professional billing- admission date matching the facility's admission date

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bshasby@gmail.com

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Hi, I am trying to find supporting documentation (mainly from CMS) that it is or is not a requirement that the admission date we use matches the facility's admission date. We are hospitalists that bill for the professional components. So if we do an H&P on 1/26/2016 and use admit date 1/26/2016 but the facility has the admission as 1/25/16, is this ok, or is a requirement that it matches? To date, we have never had a denied or rejected claim but that is not to say it is correct billing and later can be. I have combed CMS and can't find an answer to this. Anyone out there familiar? Please email responses.
brookes@alaskahospitalist.com

Kind Regards,
Brooke Shasby, CPC
 
professional billing - admission date matching the facility admission date

I do not know if there is a specific location where this information is referenced, but I do know that you should bill with the admit date in which the patient was admitted and this needs to be the same as the hospital admit date. Often there is a discrepancy, and this needs to be resolved. But they should always match.

Hope this helps,

Ardith, CGSC
 
I don't agree. I also do not have any supporting reference that I can think right now, but the physician's Initial Inpatient encounter should be billed for the DOS that (s)he actually saw the patient for the first time at the facility. This DOS does NOT need to match the facility admit date. We have this happen fairly often, and do not have any problems getting claims paid. I will try to find a reference to post here.

HTH!
 
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