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Click here for more sample CPC practice exam questions and answers with full rationale

Inpatient Admission 4 Weeks Prior to Delivery

We have a patient who was admitted to the hospital for management of her pregnancy, due to loss of a twin in-utero, 4 weeks before she delivered. The provider sent me the inpatient daily visit charges to ‘bill out’, but I am certain this still falls under the Global OB package, as we have seen her for the duration of her pregnancy (so we billed for global delivery code, as well). Am I correct in my thinking that the Inpatient services are not billable to the payer? They are bundled in with the Global OB Package?

Medical Billing and Coding Forum

Inpatient Consult/ Admission during global

I have two scenarios I’m unsure of, although I think that E/M cannot/ should not be charged.

If a patient is under a global for fracture care, and is admitted to the hospital for a medical reason by an internist, can the orthopedic surgeon bill an E/M for a consult? The consult was only to follow up/ check the fracture.

In another case, the patient is readmitted a day after discharge, s/p Total knee replacement for fevers. We admitted the patient to Observation, to rule out infection. Nothing was found, patient did not need any further surgery. Do we charge for this admission?

Thanks,
Cindy

Medical Billing and Coding Forum

Observation – Subsequent Obs – Admission by Consulting Provider

Dilemma outpatient overnight observation, subsequent observation, and admission by another provider. ED provider sees patient 15:00 hrs on DOS 1.13 , admits and follows patient in observation Dos 1.13 at 18:15 (initial obs). DOS 1.14 08:00 OBs attending orders cards consult. 1.14 08:30 Cards sees patient orders thallium stress test. 1.14 ED/OBs attending sees patient at 09:30 states pt awaiting cards consult, and stress test, disposition pending cards consult. 09:45 Stress test completed, cards decides to admit patient to inpatient status. Ed/obs provider sees patient again and states pt failed observation period and will be admitted per cardiology consult 1.14 at 11:00. The ED provider can code the initial observation service code 99218-99220 for 1.13 18:15 since they follow pt in observation, and a subsequent observation code set for the services they provide on the subsequent date 1.14. I know the provider cannot charge the DC. And if the Ed provider was the admitting provider then they could not charge for subsequent observation services. Any help would be greatly appreciated.

Medical Billing and Coding

Physician Coding Consult vs Admission

So I have a dilema where my psych doctors are doing consults in the medical floor and suggesting admission for psych care-

the next day, they create an H&P. How does the physician coding and billing work?

Do I bill the consult from the day before and then bill an H&P the next day?

Or does the consult turn into an H&P and the next day will just be a progress note?

Medical Billing and Coding