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Facility billing- Can newborns be billed as inpatient OR outpatient ?

We currently are following the 2 midnight rule in regards to billing the mother’s delivery as either outpatient or inpatient.
Initially we billed all deliveries as Inpatient but some moms leave the next day so we have now applied the 2 midnight rule to determine whether the mom is inpatient or outpatient. My question now is what about the newborn billing?? I feel like the newborn billing should match the mother’s billing, if moms billing is outpatient so should the newborns be. But up to now we have been billing the newborns as inpatient.

Wondering what input anyone has on this facility billing regarding outpatient or inpatient for Deliveries and Newborn admits/discharges.

TIA
KAM

Medical Billing and Coding Forum

Professional Inpatient Services

Inpatient claims for professional services:

We have always put the admit and discharge dates on all our inpatient claims but we have switched EHR vendors and the new vendor is telling us this information is not required. We also started working back end denials for a new group in our organization and they are not using admit/discharge dates on their inpatient claims.

What do you think? What do you do?

Medical Billing and Coding Forum

Changing patient from Inpatient to Observation after discharge

Can you change a patient status from Inpatient to Observation (or vice versa) once the patient has been discharged?
Also, can we change it just because the insurance says if you do we will pay you because the other does not meet medical necessity?

Medical Billing and Coding Forum

Coding inpatient discharge summary diagnosis

I have come across many inpatient discharge diagnosis that do not match. For example the discharge diagnosis will Schizophrenia but below that it will have the axis 1 and it will say Paranoid Schizophrenia. I was always taught to go with the "discharge diagnosis" when billing the discharge summary, however the axis 1 was more specific. Are there any rules regarding which one to use for billing the discharge summary?

thanks

Darla

Medical Billing and Coding Forum

Inpatient 90846 & 90847

Hello,

I’m a professional fee coder for a behavioral health group. Around 09/01/18, insurances have been denying inpatient 90846 & 90847 as ‘invalid place of service.’ Has anyone else ran into this or does anyone have further information? Any thoughts or advice would be appreciated.

Thanks,

Jay Mominee, CPC, CPB, CPMA, CEMC

Medical Billing and Coding Forum

Inpatient – Telepsychiatry counseling appointments – denial from Medicare

Does anyone know the revenue code for billing the CPT code (90834) on a UB04? Would it happen to be 0780 or 0789?

The facility is Part A Medicare Provider and all their claims were rejected. They are located in FL. Would we have to call Medicare in FL to find out how to reprocess these claims. If anyone has a phone number to share that would be very helpful.

I have looked all over the internet and was not able to find how to bill this correctly.

Thank you.

Medical Billing and Coding Forum

Office visit with Pulmonary Function Testing, same day inpatient consult

I have a patient that was seen in our office, complete PFT done. Later that date admitted to the hospital, and a consult was performed by the same doctor that saw the patient in the office earlier in the day.

I am under the impression that I am not able to bill the office visit, but can I still bill for the PFT?
I’m a little confused and can’t seem to find any information on this.

Thanks

Medical Billing and Coding Forum