TEST YOUR SKILLS

An established patient is seen in the provider's office and is very ill. The decision is made to admit the patient and the patient is sent directly to the hospital from the provider's office. The correct coding for this patient's care on that day would be:

Answer: b

When a patient is seen in the provider's office and admitted, the hospital admission should be the service code billed for that day. Billing for both the office encounter and the admission separately is inappropriate and 3rd party payers will not allow payment for both. The relative value for the admission CPT code is higher than the office visit code and therefore is reimbursed at a higher rate.

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