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Need Help w/ Hospital E&M!!

  1. Default Need Help w/ Hospital E&M!!
    Medical Coding Books
    If a pt is admitted to the Hospital via Er Dr or whomever, can our Physician (Internal Medicine) still code 99222(etc)the next day when he sees the pt and does an H&P on them? Or are we to code a 99232(etc) because the ER had already admitted them the day before? He is insisting that we can code a new admit for him as well. Sort of new at doing this for him and would really appreciate any help or advice to anyone that could help out. I need something to back this up. Please help!!!

    Thanks so much,
    Brenda S. CPC

  2. #2
    Default
    Quote Originally Posted by SKIRVIN4 View Post
    If a pt is admitted to the Hospital via Er Dr or whomever, can our Physician (Internal Medicine) still code 99222(etc)the next day when he sees the pt and does an H&P on them? Or are we to code a 99232(etc) because the ER had already admitted them the day before? He is insisting that we can code a new admit for him as well. Sort of new at doing this for him and would really appreciate any help or advice to anyone that could help out. I need something to back this up. Please help!!!

    Thanks so much,
    Brenda S. CPC
    Let me see if I have this correct, pt was initially seen in the ER by ER doc, now your doc is the admitting Dr. ( am I right so far). If this is the case your physician would bill the h&p. I don't know too much about how the Er docs work but sounds to me like the ER doc "admitted them under your care".

    What did the ER doc bill? I would also check the admitting record to what the hospital has.
    Anyone else!
    Roxanne Thames CPC, CPC-I, CEMC
    rthamescpci@gmail.com


    "Remember the greatest gift is not found in the store but in the heart of true friends"

  3. #3
    Default
    i agree, the ER doc bills for ER services only. Your internal med would bill for the admit on the date he/she actually saw the pt.
    Chris G. ,CPC

  4. Default
    Codes 99221 - 99223 are used by the admitting physician on the date they have the initial face to face encounter w/the patient. So if you doctor is the admitting physician, bill the level that is appropriate on the date he/she had the initial encounter.

    Kim R. CPC-I, CPC-H-I, MPC

  5. #5
    Location
    Milwaukee WI
    Posts
    4,466
    Default Who is the admitting physician
    The Initial Hospital Visit 99221-99223 is coded by the admitting physician on the first day s/he provides face-to-face service to the patient.

    ER physicians do not typically serve as admitting physician.

    If your internal medicine doc is the admitting physician, then, yes he can code 99221-99223 the first day he sees the patient, even if this is actually the day after the patient was admitted to the hospital.

    F Tessa Bartels, CPC, CEMC

  6. Smile
    Quote Originally Posted by SKIRVIN4 View Post
    If a pt is admitted to the Hospital via Er Dr or whomever, can our Physician (Internal Medicine) still code 99222(etc)the next day when he sees the pt and does an H&P on them? Or are we to code a 99232(etc) because the ER had already admitted them the day before? He is insisting that we can code a new admit for him as well. Sort of new at doing this for him and would really appreciate any help or advice to anyone that could help out. I need something to back this up. Please help!!!

    Thanks so much,
    Brenda S. CPC
    you would use the inpatient admitting code because everything will be included even the er service.

  7. #7
    Location
    Jacksonville, Florida - 90417
    Posts
    187
    Default Hospital E&M
    I have never heard of an ER physician admitting anyone. Usually the ER physician will consult the Medicine service to determine whether or not the patient should be admitted. The Medicine service could bill either a consultation or an admission code (if they decide to admit and to their admission H&P).

    - Maryann
    Maryann

    Maryann C. Palmeter, CPC, CENTC, CPCO

  8. Default
    The way I understand her to say this is, her doctor wants to bill for his ER admit and his Hospital admit is this correct? The 99222 then the 99232?? Our hospital does direct admits so I am not quite understanding what she is trying to say.
    Last edited by Cyouell; 05-01-2009 at 10:13 PM.

  9. Smile
    When the ER needs a patient admitted they normally. Would speak to the physician (ie; your doc) and then write admitting orders for the nursing staff to care for the patient until your physician comes in to see the patient. Most hospitals have a policy of with 24 hours. When your physician comes in to see the patient he would write the H&P and he bills the Admit codes 99221 through 99223 depending on his documentation and nature of the presenting problem and MDM.

    Hope this helps.

    Kevin Solinsky, CPC, CPC-I, CEMC, CEDC
    Healthcare Coding Consultants, LLC

  10. Thumbs up E&M class
    I am not sure where everyone is located but there is a Learn how to audit: teaching E&M class available in the baltimore are available to anyone that needs a quick brush up on E&M or anyone that would like to learn how to audit, or you just need ceu's the class is available this september.contact me for more info.

    Azure're Heatley
    azurereh@yahoo.com

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