Wiki Hospital Admit Charges

[mhstrauss]

Hoping to get some insight with a problem I'm having...I'm fairly confident with inpatient E/M codes, but one of my docs is making me doubt myself

Dr. A saw an established patient here in the clinic a few days ago for a follow up appointment, and sent her to a nearby hospital for a direct admit (he does have rounds privileges at this facility). He did not actually go to the hospital to admit her, but Dr. B was there to admit the patient. Dr. B is also a part of our clinic, same specialty as Dr. A, and all the docs in this group take turns, a week at a time, covering on-call at this hospital. My thoughts on this, is that Dr. A should not bill out his clinic visit; Dr. B, who is actually performing the admitting H&P at the hospital, should bill 9922x. Dr. A is quite adamant that since he "ordered" the admit, he can bill the 9922x inpatient code, from the clinic setting.

Can anyone help?! Thanks!!

 

[kjj1006]

cpc, circc, acs-ca

No, the physician who ordered the admit cannot bill the admit unless he/she is at the hospital doing the admit. The physician at the Hospital actually doing the admit can bill for the admit. 99221, 99222, 99223 are face-to-face codes.
This is called "giving away the admit"
It just is what it is.

 

[mhstrauss]

No, the physician who ordered the admit cannot bill the admit unless he/she is at the hospital doing the admit. The physician at the Hospital actually doing the admit can bill for the admit. 99221, 99222, 99223 are face-to-face codes.
This is called "giving away the admit"
It just is what it is.

My thoughts exactly! Thanks for your response!!