Are you able to bill a 99212-99215 for a doctor that sees patients while they are in the hospital as outpatient?
Are you able to bill a 99212-99215 for a doctor that sees patients while they are in the hospital as outpatient?
Hi, yes the patient would be in Observation for an issue, and our provider consults with the patient during her stay. The provider is a private practice doctor with privileges at the hospital. She has been billing out office e/m codes: 99212 - 99215 for these visits. That is incorrect?When you say "in the hospital as outpatient," do you mean that the patient is in Observation?
The E/M codes for Inpatient and Observation status are the same, as of the 2023 E/M updates.
If the patient is in Observation, you'd use 99221-99223, 99231-99233.
She is a perinatologist.Depends on the payer, usually in OBS the attending hospitalist or physician of record bills the 99221-99223 and 99231-92233 codes and specialty consultant services use 99203-99205 or 99213-99215.
Some payers would also accept the 99221-99223, 99231-99233 for the consultation services.
What specialty is your provider? If they are the attending for the OBS stay, they are underbilling.
Thank you!Hi. If the provider did not admit the patient to observation (which she likely didn't if she's a specialist) then yes, use 99202-99215 depending on if the provider has seen the patient in the last 3 years.