Billing questions

1) If a patient comes to the clinic for abdominal pain, goes home and then later gets admitted as an inpt/obs for appendicitis (something related to abdominal pain) through the ER, should the clinic visit be included in the admit charge or can we bill them both out? I know if the conditions/DX are different we can bill both out.

2) If a patient comes to the clinic and has labs/x-rays done and goes home. Later in day the physician reviews the labs/x-rays and tells the patient to go to the hospital for admission, should the clinic visit be included in the admit charge or can we bill them both out?

3) Patient comes to the clinic and then patient gets sent to hospital for IV fluids. After IV fluids are completed patient is not better and then gets admitted to inpt/obs; should clinic visit be included in admit charge or can we bill them both out?

4) Patient is seen in the clinic in the AM for post partum bleeding. Doctor tells the patient to come back to the hospital later in the day for D&C. Would we charge an office visit and use modifier 57 decision for surgery or is it included in the D&C pre-op global?

5) Patient is seen in the clinic for abdominal pain. Patient is sent to the ER for further work-up. After further work-up is completed patient gets admitted to inpt/obs; should clinic visit be included in admit charge or can we bill them both out?

6) Our doctors deliver babies at the hospital. When that baby comes into the clinic for his first WCE, shoud that patient be considered a new or established patient?

7) Our doctors see patients in the ER. When the patient comes to our clinic for follow up of that ER visit and have never been seen in our clinic or have not been in the last 3 years, would they be new or established patients?

8) Our doctors see patients in ER then admits the patients to inpt/obs, does rounds and then discharges them. When the patient comes in for a follow up of that admission and have never been seen in our clinic or have not been seen in the last 3 years, do we consider them new or established?

Thanks so much!

re: Billing questions

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