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Wiki 2 OV and a Admit on the same DOS

Lorisvg

Networker
Messages
94
Location
Appleton, WI
Best answers
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Can anyone help me with my dilemma?
A pt came to the office and saw Dr.A
Pt returned several hours later and saw Dr.B
Dr. B gave the patient IV's, and then admitted the pt to the hospital.

Is there a modifier I can use on the first visit, since there are 2 Dr.'s involved? (They use the same tax ID)

Thanks
Lori
 
Hello,
I guess these are two separate visits.
Dr.A may try: highest E/M level; Also, no modifier required.
Dr. B cannot claim.
 
Two diagnoses?

Without seeing all the notes, it's difficult to give you a definite answer, but ...

If you have two distinct diagnoses you might try -25 modifier on Dr A's clinic visit.

For Dr B you would roll all work performed into the hospital admit and determine the level by everything that was documented (both office visit and hospital admit).
You might have prolonged service in addition to the basic hospital admit note, assuming your physician has documented the additional time spent with the patient. If the patient was seriously ill, you might have critical care for Dr B.

You MAY still get a denial for the office visit by Dr A.

F Tessa Bartels, CPC, CPC-E/M
 
It was the same diagnosis for both visits, and the patient was not critical.
I am thinking that if I send in a charge for Doctor A, it will be denied as part of the hospital admit. Seeing Dr. B did the admit I want the 1st Doc to get some payment also.
 
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