Consultation and Admit same day different facilities

bkirby

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Can a group submit a consultation at one location and then, after the patient is transferred to a new facility, bill an admit on the same date of service? (Same group, different providers)

Please include any links to printable information.

Thank you!
 

msr1984

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I don't have a link, but I can tell you that which ever code hits the insurance company's system first is the one that will get paid. The other will dup out. I have had to prove this to way too many doctors. They saw the patient A in the office and sent them home, later that day patient A gets worse and wanders into the ER. The doctor admits patient A to the hospital b/c symptoms are significantly exacerbated from earlier in the day. My charge from the morning visit has already been filed and if subsequently paid. The admission is later denied-duplicate-same provider/date of service.
 
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Read CPT Guidelines

First - your post is in the wrong thread. This thread is for EMPLOYMENT issues/questions.

Please read your CPT guidelines on E/M coding. You'll find the answer clearly stated there. You code ONLY the initial hospital visit, and you use ALL documentation for that DOS to arrive at the level of service. This assumes that all service is done by one provider OR that it is done by partners in the same practice and of the same specialty.

Hope that helps.

F Tessa Bartels, CPC, CEMC
 
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