Health Information Management

Billing infusion hours when there is an order to admit

HIM-HIPAA Insider, June 23, 2009

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Q: A patient in the ED is receiving infusion services. A physician writes an order to admit that patient as an inpatient to the regular floor. However, the patient sits in the ED for three hours waiting for a bed. Should the ED continue to bill for hours of infusion while the patient waits for a bed and as the service is provided, or does time stop when the admit order is written?

A: A patient becomes an inpatient at the time the physician writes an order for inpatient admission, regardless of whether the patient is still located in the ED. For this reason, although ED staff members continue to provide the infusion service for the patient, this service is part of the inpatient care for the patient. Providers should not bill infusion hours as an outpatient service under the outpatient prospective payment system by the ED after the time the inpatient admission order is written.

Editor’s note: Kimberly Anderwood Hoy, JD, CPC, regulatory specialist at HCPro, Inc., answered this question that appeared in the June issue of Briefings on Coding Compliance Strategies.



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