Wiki 99234-99236

[dvance4210]

This question may have been on another thread but I couldn't find the same scenario. I have a hospitalist who admitted the patient and did the H&P but another hospitalist from the same group discharged the patient on the same day...who gets the charge for the 99234-99236, the admitting or discharging doctor?

 

[SharonCollachi]

The admitting physician is the physician of record, unless he transfers care to someone else. Another physician in his group can fill in for him for the discharge, but the physician of record still bills the combo code. I think item 3 below is a bit misleading, as it does not say that it is combined into one code or billed separately, but I think we can surmise that they mean one physician bills although two physicians from the same group practice can write the notes.

From The Hospitalist (it is for observation but is same for admission):

If a patient is both admitted and discharged on the same calendar date, the code range of 99234-99236 are used; however, the following criteria must be met:

1. The patient must be in observation for a minimum of 8 hours.
2. The billing physician must be present and show active involvement by charting condition updates, orders, etc.
3. Both the admission and discharge notes are written by the billing physician (or may be billed by 2 physicians within the same group practice).