This is a paste from CMS:
When the patient is admitted to the hospital via another site of service (e.g., hospital emergency department, physician’s office, nursing facility), all services provided by the physician in conjunction with that admission are considered part of the initial hospital care when performed on the same date as the admission.
It is better--and you want him to code--the "direct admit" encounter as an initial inpatient. Look at it this way, your Physician only gets one E&M service per day (generally). He can code the OV or he can code the Initial inpatient.
If he codes the OV E&M, it will probably be denied as records will show was patient was Inpatient status on that DOS.
The initial inpatient E&M codes generally have a higher RVU and reimbursement than the OV E&M (depending on level coded).
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