decisionhealth Newsletters, Coder Pink Sheets - 2008 Issue 11 (November)
ObGyn must see patient in hospital to bill “admission”
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Article Overview
This article discusses evaluation and management coding for ObGyn patient encounters that begin in the office and continue into a hospital setting. It focuses on how the timing and location of the physician’s face-to-face encounter affects whether services are treated as part of initial hospital care or separately reportable office services. The article is relevant to ObGyn practices, coders, billers, and anyone handling inpatient admission documentation and claim submission.
Why This Topic Matters
Correctly distinguishing office services from hospital admission-related services can affect claim submission, denial risk, and the need for supporting documentation. The article also highlights how encounter timing and documentation practices influence whether standard hospital E/M reporting is available or whether alternate reporting may be needed.
What You Will Learn
- How office and hospital encounters are evaluated for E/M reporting purposes
- Why the timing of the physician’s hospital encounter matters for admission-related billing
- When separate documentation for different settings may be relevant
- Why documentation practices can affect whether standard hospital E/M reporting is available
Who Should Read This
- ObGyn physicians
- Medical coders
- Medical billers
- Revenue cycle staff
- Practice managers
Codes Discussed
Code Ranges Discussed
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