physician billing

  1. T

    Question Modifier 53 for ASC Procedure?

    I do physician billing (not billing for the facility) and the doctor documented that after anesthesia was administered the patient's "heart rate increased to 120-130 with some decreased bp so procedure not preformed, will need cardiology eval and may consider trusp under local w cognitive...
  2. E

    Question Chronic Vent Management? Physician Fee?

    If the patient arrives with a current chronic vent, can the hospitalist bill for 94002 vent management, initial day? We can find information it cannot be billed with an E/M, but for the initial day, does the provider also need to initiate the pressure or volume in order to code? No luck with any...
  3. B

    99222 and 32555?

    Help! I'm hoping someone may be able to shed some light on a billing question I and my boss have. :) We admitted a patient on 12/27/17 for Shortness of Breath (R0602), Abnormal Coagulation Profile (R791), Sepsis (A419), Hypokalemia (E786), Essential Hypertension (I10), Thyrotoxicosis (E0590)...
  4. L

    How to bill physician consult while patient in acute care hospital on observation

    Hi everyone, I am not understanding this scenario: Patient is located in an acute care hospital, but is on observation status for three days then discharged. The physician was brought in on a consult, and is billing POS 22, 99252 for day 1, and for day 2 is billing POS 21 and 99232. I thought...
  5. L

    Physician not reporting critical care time

    I have a problem with a physician in our ED not reporting his critical care time so the facility can report it for the revenue. I am trying to find documentation on CMS or any other supporting site to take with me to Quality Assurance to let them know manipulating documentation for maximum...
  6. M

    Subsequent Hospital Visit and Discharge Management on Same Day

    Need help on this please. Thanks! :) How should the physician bill if they provide subsequent hospital care visit before the patient dies on the same day? I know that physicians may not bill for both a hospital visit and hospital discharge management for the same date of service. Scenario: On...
  7. M

    Physician Billing in a CAH

    Can ER/ED physicians bill Medicare Directly when working in a CAH. From my research, i believe it depends on the physician contract with the hospital. Thanks in advance Mike You can email directly at
  8. M

    Physician billing in a CAH

    Can ER/ED physicians bill Medicare directly for services performed in a CAH? It appears from my research the answer is yes but I am trying to find someone who has actual experience or direct knowledge. Thanks in advance Mike