Can I bill an initial IP visit for 2 providers of same specialty within 60 days?

[mtsoldevila]

Provider A saw the patient on 5/20/22 and billed 99222. Patient was readmitted on 6/19 /2022, and another provider from the same group specialty did the consultation this time. Can I billed an initial code for this 2nd provider or a subsequent one?

 

[thomas7331]

Provider A saw the patient on 5/20/22 and billed 99222. Patient was readmitted on 6/19 /2022, and another provider from the same group specialty did the consultation this time. Can I billed an initial code for this 2nd provider or a subsequent one?

You should bill an initial visit for the first visit for each admission (assuming documentation supports it). There is no requirement for a specific amount of to elapse between initial visits. A new admission requires a full work-up by the provider, even if the patient happened to have just been discharged recently.

 

[mtsoldevila]

Thomas, what about the rule that you cant bill an initial visit twice within 60 days? Re admission is for the same dx.

 

[thomas7331]

Thomas, what about the rule that you cant bill an initial visit twice within 60 days? Re admission is for the same dx.

What rule are you referring to? Are you speaking of the Medicare inpatient benefit period which starts again 60 days after discharge? That wouldn't affect physician coding, as far as I'm aware.

 

[mtsoldevila]

Thanks Thomas. I coded as initial since its a new admission. I got it now.

 

[OpenClaims]

Provider A saw the patient on 5/20/22 and billed 99222. Patient was readmitted on 6/19 /2022, and another provider from the same group specialty did the consultation this time. Can I billed an initial code for this 2nd provider or a subsequent one?

Yes, these were two separate initial visits handled by two separate physicians.

 

[Robyn07]

Each Admission is a separate episode of care. Think of it that way and that may help.