Wiki ADM FOR SOTALOL 2 different questions

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MARCYL

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HI,
If you see a pt in the office and set them up to come nito the hospital in about 10 days for sotalol load can you bill for an adm code if you do a seperate note, and it was planned? The CV will be done the next day after rounding on the pt and recording a note as to if the medicine did the job or not. Can the rounding visit be charged on the same day as the CV if there is a seperate note?
 
MARCYL said:
HI,
If you see a pt in the office and set them up to come nito the hospital in about 10 days for sotalol load can you bill for an adm code if you do a seperate note, and it was planned? The CV will be done the next day after rounding on the pt and recording a note as to if the medicine did the job or not. Can the rounding visit be charged on the same day as the CV if there is a seperate note?
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We bill this quite often even for a scheduled admit; because the provider is not doing a procedure per se, there isn't a CPT code to use so it is appropriate to bill an admit.
Use Dx code V58.83 and the code for the arrhythmia, usually 427.31.
 
Thanks we are the adm, attending and the ones doing the procedure. Would we still bill an adm and can we bill a rounding charge on the day of the procedure?
 
Our patients are generally inpatients for 3 days and we bill an admit on day one and follow-up visits for the next two days, generally 99233 as these patients need careful monitoring.
 
Admission for Sotalol

What level do you normally assign/consider for the planned admission for Sotalol? (Patient seen one week prior with decision to follow this treatment plan.) I find in my case that the MDM meets a moderate level. Since the patient presents as they would for a planned procedure, the decision-making has essentially already been completed (at the previous office visit where the decision was made for this treatment); however, treatment still carried out this day to include the intensive monitoring.

Based on medical necessity do you lean toward 99221 since it was a planned admission? Likely if the only problem the patient has is the atrial fibrillation, the MDM would be LOW complexity.

In my case they presented with the atrial fibrillation (which I considered established problem, worsening - 2 points) and elevated BP in the setting of hypertension which they are going to monitor closely (1 point - some may argue 2 points). I have 2 data points and the chronic illness with exacerbation. So, I feel comfortable reporting 99222.

My physician wants to report 99223. What are others thoughts on the admit E/M level for planned admissions for Solatol treatment?

Thank you!
 
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