Per the CPT guidelines, the admitting physician get's credit for the Admit code. It would be 4/22, because that is the official admitting DOS based on the hospital records. The insurance company will deny if the dates of admit and discharge are different than your provider from the hospital's.
If the provider had not admitted the patient, he would have been entitled to the ER CPT code on 4/21, because that is the date he was seen first. It is a tricky situation and a good question.
It takes time to evaluate the patient and get the orders written.
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