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Thread: inpt vs outpt

  1. #1

    Default inpt vs outpt

    AAPC: Back to School
    The hospital has started changing some of our direct admit patient's who are going to have surgery to outpt. We typically would post a no charge from the office and charge a hospital admit code. Now that they are changing the stay to outpt do you feel it is appropriate to charge the office visit? Or what do you think we should do?

  2. #2
    Join Date
    Apr 2007
    Milwaukee WI

    Default Why is the hospital changing the status?

    Why is the hospital changing the status? Don't the doctor's order count for anything?

    If the physician provided an initial hospital visit with a clear plan to "admit" the patient as an inpatient, I don't see how the hospital can decide it's outpatient.

    If the patient is, in fact, having an outpatient procedure, then you would code either the office visit with your decision for surgery modifier. Or, you might code the admit to observation with a -57 modifier.

    It's hard to give a definitive answer without seeing all the documentation.
    Hope that helps.

    F Tessa Bartels, CPC, CEMC

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