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outpatient or inpatient

  1. Default outpatient or inpatient
    Medical Coding Books
    Patient was scheduled for an outpatient angiogram. But after the angiogram it was decided that he needed a bypass the same day. How do I bill the angiogram, as an out patient or inpatient.

    The patient got admitted right away.

    Please advise.

  2. Default Outpatient or Inpatient?
    In the Cpt codebook under, " Initial Hospital Care, New or Established Patient" it states :

    When the patient is admitted to the hospital as an inpatient in the course of an encounter in another site of service (eg. hospital emergency department, observation status in a hospital, physician's office, nursing facility) all evaluation and management services provided by that physician in conjunction with that admission are considered part of the initial hospital care when performed on the same date as the admission. The inpatient care level of service reported by the admitting physician should include the service related to the admission he/she provided in the other sites of service as well as in the inpatient setting.

    Hope this helps.

  3. Default
    Quote Originally Posted by TonyaMichelle View Post
    In the Cpt codebook under, " Initial Hospital Care, New or Established Patient" it states :

    When the patient is admitted to the hospital as an inpatient in the course of an encounter in another site of service (eg. hospital emergency department, observation status in a hospital, physician's office, nursing facility) all evaluation and management services provided by that physician in conjunction with that admission are considered part of the initial hospital care when performed on the same date as the admission. The inpatient care level of service reported by the admitting physician should include the service related to the admission he/she provided in the other sites of service as well as in the inpatient setting.

    Hope this helps.
    The above is applicable when its an e/m code. But my question was regarding the place of service for the angoigram/cath, should it be outpatient or inpatient.

  4. #4
    Default
    Quote Originally Posted by peeya View Post
    The above is applicable when its an e/m code. But my question was regarding the place of service for the angoigram/cath, should it be outpatient or inpatient.
    I would bill it as an outpatient. The procedure findings cause the patient to go from outpatient to inpatient

  5. #5
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    Birmingham, Alabama
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    Default
    Quote Originally Posted by Jim Pawloski View Post
    I would bill it as an outpatient. The procedure findings cause the patient to go from outpatient to inpatient
    I agree with Jim. Angio is outpatient, bypass is inpatient.

    HTH
    Danny L. Peoples
    CIRCC,CPC

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