Bill For Date of Admission or Date of Face-To-Face Evaluation

A reader posed this question about whether their doctors should bill for the hospital admission date or the date the doctor sees the patient:  Help. My hospitalists I support for coding and documentation have gone astray. They think they should bill admission code with the date of the admission, not the date they have first face-to-face encounter. Can you please help? Thank you.

Your hospitalist had best listen to your advice.  What the hospital lists as the admitting date makes no difference for the doctor evaluating the patient.   The doctor can only  bill a CPT® code on the day the service was provided.  See the AMA's CPT 2013 Standard Edition for complete details on CPT® codes.    That means if the patient was admitted at 10:00 PM May 4th with telephone orders but did not get their face-to-face encounter or H&P until 8:00 AM on May 5th, the doctor can only bill an H&P on May 5th.  The orders on May 4th are a freebie.  There is no billable code for telephone orders.

I hope that helps  You can see much more in my free lectures on hospitalist coding and my resource center to understand the economics of your practice environment.

LINK TO E/M CODING CARD POST EM Pocket Reference Cards Using Marshfield Clinic Point Audit One Hospital: (Admit/Consult) One Side, Follow-Up On Other Side $10.00 One Clinic: (New/Consult) One Side, Established On Other Side $10.00 Two Hospital Cards $16.00 Two Clinic Cards $16.00 One Hospital Card + One Clinic Card $16.00 Two Hospital Cards + Two Clinic Cards $29.00 Click image for high definition view