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Thread: hospital admit

  1. #1

    Question hospital admit

    If a private pay patient comes into the office to see the physician and is admitted to the hospital can you charge a office visit? I know if it is Insurance related you can charge for the hospital admit, but you cannot charge for the office visit. Please help

  2. #2
    Join Date
    Apr 2007
    Location
    Yuma
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    I would say yes you can. Remember you can charge a office visit for insurance but they just wont cover the service!
    Herbie W Lorona Jr., CPC, CPC-H
    hlorona@up2parmedicalclinic.com

  3. #3

    Smile fmck

    You should only charge for the admission....if it were Ins you would only
    bill for the Admit. Always post your charges for private pay the same as
    you would for Insurance-private or Medicare/Medicaid.

  4. #4
    Join Date
    Apr 2007
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    Quote Originally Posted by FMCKELVEY View Post
    You should only charge for the admission....if it were Ins you would only
    bill for the Admit. Always post your charges for private pay the same as
    you would for Insurance-private or Medicare/Medicaid.
    I agree. You should not bill self pay any different than you would an insurance company. Still follow the same coding guidelines.

    Happy Coding!
    When will I get my results????Going insane!!!!
    Jeni Smith, CPC, CPMA

  5. #5

    Default

    Quote Originally Posted by kimb View Post
    If a private pay patient comes into the office to see the physician and is admitted to the hospital can you charge a office visit? I know if it is Insurance related you can charge for the hospital admit, but you cannot charge for the office visit. Please help
    Hi,
    Doctor should be charging for a high-level office visit and when he/she sees the patient the following day in the hospital, the initial hospital care code given. This is correct if the doctor does not visit the hospital on the date of admission.
    But, if on the same day of patient's admission to the hospital, the doctor visits the patient, only initial hospital care codes are given. Office visit is not coded.

  6. #6
    Join Date
    Apr 2007
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    If an office visit ends up with a hospital admit, the admit only should be coded - provided the physician does see the patient in the hospital. Otherwise, you can't bill an admit without the proper place of service, therefore the office visit is the appropriate code. (as stated in the above post). As always, make sure documentation supports your level of service no matter what the place of service is...
    Lisa Bledsoe, CPC, CPMA

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