Results 1 to 2 of 2

ER Visit with Pending Admit

  1. Default ER Visit with Pending Admit
    Medical Coding Books
    I am confused about billing in or outpatient codes with ER Consult or NP Visits. I know that coding material that I have read says to bill as an OP if you see the patient in the ER, but many of our patients are in the process of being admitted. Many times they are being admitted by another physician so they end up to be an inpatient. Our doctors often see patients in the emergency who are going to be admitted by another physician because of the overcrowding, and we do not have an immediate bed available. Also, I have found that when I bill an outpatient code for a patient that ends up to be admitted many insurance companies do not recognize the place of service 22 or 23 with the outpatient NP Consult or NP visit codes. They keep trying to get me to bill a ER visit code, which is usually billed the the ER doctors.

    I would appreciate any thoughts.



  2. #2
    Milwaukee WI
    Default Who is requesting the consult
    Who is requesting the consult? If the ER physician is requesting the consult then I'd code the outpatient consult with POS 23.

    If it's the admitting physician who is requesting the consult, then I'd code the inpatient consult code IF you're sure the patient is being admitted that same day,even though you are seeing the patient in the ER because the hospital hasn't a bed for admission yet. If they don't actually get admitted until the next day, then I'd go back to the outpatient consult codes.

    I'd appeal your denials with documentation.

    What specialty are you coding for? You might want to post this question on THAT thread (e.g. gastroenterology) ... most of the responders on this ER thread will be coding for ER (doctors or facility).

    F Tessa Bartels, CPC, CEMC

Similar Threads

  1. Admit vs office visit
    By TrishFLmom in forum E/M
    Replies: 5
    Last Post: 10-15-2013, 08:18 AM
  2. ER visit then Admit
    By bmanus in forum Emergency Department
    Replies: 2
    Last Post: 04-24-2013, 11:39 AM
  3. ER Visit with subsuquent Admit
    By mhadsell in forum E/M
    Replies: 0
    Last Post: 03-27-2013, 02:50 PM
  4. Office visit and admit
    By carol52 in forum E/M
    Replies: 2
    Last Post: 01-23-2013, 12:32 PM
  5. Clinic Visit and then an Admit
    By kishacajun in forum Family Practice
    Replies: 3
    Last Post: 04-09-2010, 11:18 AM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?


Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.