Wiki Hospital Admit

[tbolla]

Is it possible to be reimbursed for a hospital admit code (such as 99223) on the day of surgery? This is assuming the surgery was scheduled as it was a patient who has been seen in the office and not seen in the ER or as a consult.

Thanks in advance!

 

[kari2007]

If the surgery is scheduled, than it is not medically necessary to do a H&P. It is probably in your hospitals bylaws that one needs to be done but unless you can append the 57 modifier, decision for surgery to it, than most payers will not reimburse you and will bundle it into the procedure.

 

[tbolla]

Thank you for the reply! That makes sense to me.