Inpt or ED?
Scenario - A patient is seen in the ER and is admitted as an inpatient to the ICU. They do not physically make it to the ICU due to bed capacity and are held in ED hold. A H&P is done by the hospitalist. Patient gets transferred to another facility while awaiting a bed in the ICU before actually ever being moved physically out of the ED but per the admission order is in an inpatient status.
Does this just get billed as an ED outpt visit or because of the admission order and H&P, this would stay as an inpatient?
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If they were admitted due to an inpatient admission order by someone authorized to do so (check staff bylaws, CMS, state regulations), I would say inpatient.
I have to know how long between the inpatient order and the transfer. Minutes? Hours? Days?
hours
oh, you're gonna make me pry it out of you. :-)
2 or 3 hours? ED billing
8 to 12 hours? Bill the inpatient stay
If the patient has an order to admit, care as an inpatient should have begun while the patient was still physically in the ER. The status should have been updated to inpatient, bed charge for the appropriate level of care generated, and this should be an inpatient transfer.