AHA Coding Clinic® for ICD-9 - 2009 Issue 3; Clarification

Clarification of Coding of Outpatient Encounters with Subsequent Admission Billing Instructions

We have received a request to clarify billing instructions for outpatient encounters/procedures in the hospital outpatient department which subsequently lead to an inpatient admission at the same facility. Hospitals are asking whether a single inpatient claim should be submitted, or whether both an outpatient and an inpatient claim should be submitted. Hospitals are advised to contact their individual payers to obtain billing instructions on this issue. Further, billing advice quoted in prior issues of Coding Clinic concerning Medicare billing (March-April 1985, pages 10-11) has been updated and changed. Coding Clinic does not provide detailed billing instructions for any payer...

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