Trendale
Guru
Hello,
Can someone help with the following scenarios?
A general surgeon who is on call or who admits the patient from the ER.
The general surgeon who I code for has been billing the H&P using the inpatient consult codes.(99251-99255) he says another doctor calls him to see the patient. The H&P report does not specify a requesting doctor and on the face sheet it says the general surgeon is the admitting doctor. In my opinion, I should code the the initial hospital codes 99221-99223, and If he should do a surgery, append a modifier 57 to the vist. The physcian insit he can bill the initial inpatient codes.
Also in the surgery guidelines in the CPT book, when it says, the surgery includes the H&P immediately prior to surgery and the subsequent imediately prior to surgery.Does this H&P refers to when the patient comes into the office and and has his/her preo visit? (This is the one you don't charge right?) Now when the patient is in the hospital and has been admitted and the physcian does the H&P, this is the one I can charge right? ( But the issue was if I should be using the Inital hospital or inital inpatient codes for this H&P.
Second scenario:
If the physcian does an initial consultation on 4/10/09 and recommends surgery, but the surgery will be contingement on more test, once the test are confirm, then he will make his decision. The test reults came, the doc decides to perform the surgeryhe initially recommended. He does a susequent visit on 4/11/09, and documents decision for surgery. Do I charge the initial consult with a 57 even though his decision for surgery was not final, and not charge the subsequent vist as this would be included?, or do I not charge the initial consult and bill the subsequent with a 57 since his decision was final on the subsequent vist? In the past, for this scenario, I have been billing the initial consult and including the subsequent in the surgery.
Can someone help with the following scenarios?
A general surgeon who is on call or who admits the patient from the ER.
The general surgeon who I code for has been billing the H&P using the inpatient consult codes.(99251-99255) he says another doctor calls him to see the patient. The H&P report does not specify a requesting doctor and on the face sheet it says the general surgeon is the admitting doctor. In my opinion, I should code the the initial hospital codes 99221-99223, and If he should do a surgery, append a modifier 57 to the vist. The physcian insit he can bill the initial inpatient codes.
Also in the surgery guidelines in the CPT book, when it says, the surgery includes the H&P immediately prior to surgery and the subsequent imediately prior to surgery.Does this H&P refers to when the patient comes into the office and and has his/her preo visit? (This is the one you don't charge right?) Now when the patient is in the hospital and has been admitted and the physcian does the H&P, this is the one I can charge right? ( But the issue was if I should be using the Inital hospital or inital inpatient codes for this H&P.
Second scenario:
If the physcian does an initial consultation on 4/10/09 and recommends surgery, but the surgery will be contingement on more test, once the test are confirm, then he will make his decision. The test reults came, the doc decides to perform the surgeryhe initially recommended. He does a susequent visit on 4/11/09, and documents decision for surgery. Do I charge the initial consult with a 57 even though his decision for surgery was not final, and not charge the subsequent vist as this would be included?, or do I not charge the initial consult and bill the subsequent with a 57 since his decision was final on the subsequent vist? In the past, for this scenario, I have been billing the initial consult and including the subsequent in the surgery.