Wiki Hospitalist and General Surgeon Visit on same day

[missyah20]

Good Morning,
Our General Surgery group recently became hospital employees and since they transitioned to the hospital Tax ID we have had issues with visits denying when a hospitalist sees the patient on the same day as our provider. Is there a way to get our charge paid or would these visits need to be billed together?

 

[thomas7331]

Those denials are either a payer error or a credentialing problem. Visits by providers of different specialties on the same date should not be a problem. Check with your payers to make sure they have your providers set up with the correct specialties in their systems.

 

[csperoni]

Agree with @thomas7331. I will just add if you are billing for both providers using the "initial" inpatient 99221-99223, SOME carriers will only pay 1 provider for the "initial" and instruct all other providers to bill using "subsequent" 99231-99233. This is contrary to CMS guidance, which definitely allows multiple providers of different specialties to use initial with the admitting using -AI modifier.
If you are using initial inpatient codes, check your carrier policy.