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Thread: Observation/Initial Hospital Care/Consultation

  1. #1

    Question Observation/Initial Hospital Care/Consultation

    AAPC: Back to School
    Any one help me out please.

    A doctor sees a patient briefly in the hospital to determine IF the patient needs to be admitted or not based upon minimal examination. He is filling out the basic orders to admit the patient. However, he is not techincally the admitting doctor, and the attending will do a full exam, H&P, etc within 24 hours. He merely makes the decision that the patient should or should not be admitted. The attending doctor wants to be able to bill the full admit charge.

    He has seen the patient face-to-face and makes the call to admit. Does he have a billable service? I am sure it would be a low level code, but what set of codes? Observation care (or is that pretty much reserved for Admit and Discharge within the same day)? OR might this be a consult?


  2. #2


    If the physician sees this patient in ER/HOPD and he bills under a different billing id to that of the admitting physician, he can bill his service with 99201-215 or 99281-285 codes (or) as consult (99241-245) if the consult criteria is met. If the billing ids are same for both the physicians, all the services will get bundled in to 99221-99223 series for the admitting physician.
    Jagadish, CCS-P, CPC

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