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Bill ER and admit same day

  1. #1
    Default Bill ER and admit same day
    Medical Coding Books
    If patient is seen in the ER and is admitted by the Hospitalist can both charge?

    Patient has Medicare insurance

  2. #2
    Quote Originally Posted by perkins05 View Post
    If patient is seen in the ER and is admitted by the Hospitalist can both charge?

    Patient has Medicare insurance
    You probably already found the answer to this, but I thought I'd reply, anyways...As long as they're not the same provider, then yes. Append the AI modifier to the admitting physician's charge. There are a couple of ways this can work:
    1. If the ER doc admitted the patient, then the Hospitalist saw them, you'll bill an Initial Inpatient code for both of them, and add an AI modifier to the ER doc's charge.
    2. If they saw the ER doc in the ER only, and the Hospitalist did the admit, bill an Emergency Department E/M for the ER doc, and an Initial Inpatient for the Hospitalist, with the AI modifier.

    So basically, you'll only bill an ER code, if the ER doctor saw the patient, and didn't admit them. Otherwise, you'll code the most intensive site of E/M service (Inpatient)...I attached a chart that you might find useful, in the future. Hope that helps!
    Attached Images Attached Images

  3. #3
    Thanks Brandi for responding...

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