Wiki 99223 versus 99233

[mpetrulo]

When my docs see a new patient for the first time in the hospital I bill 99223-Inital hospital visit.If the same pt is seen again in the hospital 2 weeks later for the same diagnosis I would bill a 99233-subsequent visit.I have been told that this is incorrect.
My interpretation of the codes tell me my way is correct.Can anyone shed some light?
Thank you

 

[ppalmer]

99223 is appropriate for each seperate admission as long as it is the initial visit and your doc meets all of the documentation requirements.

 

[Peter Davidyock]

Who is the payor?

 

[davidsnk]

Each time the patient is admitted, you bill an initial for the first day seen. The payer should not matter.

 

[Peter Davidyock]

If this is a Re-Admit and the payor is Medicare it most certainly matters. But we need some more details. When was the initial discharge? Medicare has a very strict policy about readmissions. Their reasoning is that if the issue could of been resolved in the 1st stay by extending the stay then the hospital course should of been extended. They tend to get their nose bent out of shape when there is a discharge billed and two or three days later there is a second admit billed.