cdcpc
Networker
I've thought this through and I'd like confirmation before advising my physician.
My question is: in this scenario, is it appropriate to charge 99223?
Dr. A sees a patient in the ICU and performs an H/P. This patient presented to the ER unable to move arms and legs and Dr. A assumes he will be admitting the patient. However, due to the patient's condition, the patient was later transferred to a different hospital. Here is part of Dr. A's dictation:
" PLAN: I called on neurologist, Dr. B, and reviewed this case. He feels that given his age and the new onset that he should be transferred to a tertiary care hospital. I have placed a call to the doctors access line and I am waiting for their response. In the interim I am going to begin a workup for the fever including blood cultures, urine culture, a chest x-ray, and I am going to start broad spectrum antibiotics. I am also going to request an MRI of the head and the cervical spine although if he is transferred before the tests are completed, then I will defer that to the receiving institution."
Dr. A clearly started the visit meaning to admit the patient. Once he determined the patient needed to be transferred, he still ordered tests in case there was time to complete them before the patient was transferred. The rest of the documentation had a comprehensive history, comprehensive exam and a high complexity medical decision making.
I've looked at other codes and none seem to fit the scenario as well as the admit codes, but I wanted to see what others thought.
Thanks a bunch!!
My question is: in this scenario, is it appropriate to charge 99223?
Dr. A sees a patient in the ICU and performs an H/P. This patient presented to the ER unable to move arms and legs and Dr. A assumes he will be admitting the patient. However, due to the patient's condition, the patient was later transferred to a different hospital. Here is part of Dr. A's dictation:
" PLAN: I called on neurologist, Dr. B, and reviewed this case. He feels that given his age and the new onset that he should be transferred to a tertiary care hospital. I have placed a call to the doctors access line and I am waiting for their response. In the interim I am going to begin a workup for the fever including blood cultures, urine culture, a chest x-ray, and I am going to start broad spectrum antibiotics. I am also going to request an MRI of the head and the cervical spine although if he is transferred before the tests are completed, then I will defer that to the receiving institution."
Dr. A clearly started the visit meaning to admit the patient. Once he determined the patient needed to be transferred, he still ordered tests in case there was time to complete them before the patient was transferred. The rest of the documentation had a comprehensive history, comprehensive exam and a high complexity medical decision making.
I've looked at other codes and none seem to fit the scenario as well as the admit codes, but I wanted to see what others thought.
Thanks a bunch!!
