Hospital visit

Pt was admitted to the hospital. We billed hospital visits for doc (99223-99232), but ins denied because there was no prior auth. Called hospital to find out why. They said pt was transferred to observation unit. The auth they had is for observation and not for inpatient. They changed her admission to the hosp. Can I make a new claim and bill it out as Observation?

re: Hospital visit

You should be able to, with outpatient POS.

re: Hospital visit

...And the appropriate outpatient CPT® codes

re: Hospital visit

So I can use 99218-99226 CPT® code without any problem?

re: Hospital visit

That should work. Worse case you might need to send it as a "corrected" claim with a note that your provider was unaware that status was OBS, not inpatient.

re: Hospital visit

It's important to match the status of the physician bill with the status of the facility bill. This can change AFTER the patient is discharged, and if this happens frequently, it's worth it to check with the facility before submitting the bill.

I used to say, bill each hospital visit each day: get the charges in. Now, I recommend waiting until the discharge so the correct status is known.