Direct Admission from clinic

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Direct Admission from clinic

Postby Shoshana » Tue Jan 02, 2018 7:35 pm

Can the visit from the clinic count as the Observation H & P for the hospital (99218-99220) or does the physician have to have a direct face-to-face after the admission to bill for this service?
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Shoshana, BA, CPC, CPMA, CPCO, RRT
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Re: Direct Admission from clinic

Postby admin » Sat Jan 06, 2018 3:55 pm

If the provider that saw the patient in the clinic, has the ability to see the patient in observation, and to admit them to observation, the documentation could be used to support the E/M, however if it is the only documentation then only the POS of clinic would be supported, so regular E/M services (99201-99215) would be used not observation codes.

If the provider does NOT have admitting privileges, then no, it cannot be used.

Your question has been answered by Omega Renne, CPC, CPCO, CPMA, CEMC, CIMC
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