Forum - Questions & Answers

Sep 3rd, 2015 - d.berry

Initial OV & Hospital Admission

What is the billing protocol when you see a new pt. in the office for an E/M & later, ( 1-2 days or 1-2 wks.), admit the patient for surgery with the same diagnosis? The insurance usually denies for the initial hospital admission. I've tried to research info to see if there is a global period between an initial E/M in the office and an admission. Can you bill if the physician sees the patient in PAT? Thank you......

Sep 8th, 2015 -

re: Initial OV & Hospital Admission

If you are talking about the surgeon, the global period includes the day of surgery so you cannot bill separately for an H&P on the day of surgery. You get the initial office visit to determine the need for surgery then the surgery global payment. No extra for H&P or PAT visit.

Sep 8th, 2015 - petunia 195 

re: Initial OV & Hospital Admission

If there was no decision for surgery on the initial office visit and your provider was managing the patient without opting for surgery you can bill the Hospital admission as a decision for surgery, but only if the decision was clearly made on that day. If surgery was discussed at all on the previous office visit I would not bill for the admission.

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