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ER vs Admission - HELP!!

  1. Default ER vs Admission - HELP!!
    Medical Coding Books
    Scenario - Patient is seen in Emergency Room and physician writes order to be admitted at 23:30 (11:30pm) on 4/5/10. Hospital does not give admission date until 04/06/10 at 02:00 (2:00 am) when patient has reached the designated floor bed. I know date of admission should be 4/5/10. MD bills for admit on 4/5/10. But, hospital will not change date of admit because patient was not precerted for that day. What recourse do I have and also where is it in writing, i.e. CMS, Medicare, etc.

  2. #2
    Nashville AAPC Chapter
    If the ED physician is the one admitting you would use an ED code from the 99281-99285 code set for 4/5/10.

    If the hospitalist is billing the admit, use the 99221-99223 code set for 4/6/10. It is a waste of resources on your part to argue the semantics. There is no way the hospital can move fast enough to get a patient on the floor in 30 minutes or less.

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