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Hospital observation

J

jberg

Member
I have a case where Dr A admits a patient to hospital observation but calls for a consult by the Pediatrician, Dr. B who comes and does documentation and then discharges the patient the next day. The patient's insurance does not recognize consult codes. The patient was in observation for 12 hours. Can I code for both doctors. Dr. A did do dictation on the H & P for the admit and Dr. B has dictation on his consult. I did do the discharge code for the discharge for Dr. B
Any help would be greatly appreciated.
 
A

Alicia Scott

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You know I think you can but I wanted to get our CIC Tammy in on this as she is also an CPC-H. With her auditing experience I think she can give us the best answer and they "whys".
 
A

Alicia Scott

Moderator, CCO Instructor
Staff member
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Blitzer
PBC Student (CPC®)
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ICD-10-CM Student
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Tammy was out a couple days but sent this to me via e-mail to answer your question:

You didn't mention the specialty of Dr A, but I will assume it isn't Peds. Yes, you can bill for the admit to OBSV for Dr A, and bill an OUTPT visit code for Dr B since the patients insurance doesn't recognize consult codes. Discharges can only be billed by the admitting Dr.(or someone in his/her practice with the same specialty and tax ID.)

Hope this helps!
Tammy
 
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