Wiki H and Ps

[Jennifer George]

Hi, I work for an Oncologists office and have a question that is up for debate in our office. First of all, one of our doctors saw a patient for an OV and put in an order for the patient to be admitted to the hospital in three days along with orders for their inpatient chemo care. Would the doctor bill for the OV for the day he saw the patient in the office? Who would be considered the admitting physician for this patient? Could he do the H and P in the office for the hospital stay?

 

[Peter Davidyock]

The short answer is yes.

So long as the documentaion meets the required level for the office visit your physician can bill that office visit on that dos and then if he/she sees the pt in the hospital 3 days later can reference that documentaion as part of his/her initial hospital visit. If a procedure is performed (90 day global)on the day of or the day following the admit an initial hospital visit (and a subsequent visit if the procedure is done on day 2) is bundled because this is a planned admit/procedure. Nevertheless the office documentation can be referenced.

He/she would be the admitting physician. But the documentation cannot be expressed as three days in the future. It must be documentation for the particular dos of the office visit.

Bear in mind that 99221, 99222 and 99223 although used for hospital admissions are not defined as such. They are defined as initial hospital care per day and there are guidelines that allow H&P's from ov's to be used.