Wiki Initial Hospitalization Payment

[neena.kumar@gmail.com]

Though CPT code 99222 is a per day code is it ok to have two different claims for initial hospitalization code 99222 both with Modifier 25 are paid for the same patient, to the same doctor for the same date of service. Please let me know your thoughts. Thanks, Neena

 

[csperoni]

You may not bill 2 units of 99222 for the same physician the same date.
If the same physician rounds in the morning, and again later in the day, the coding would be determined by the combined notes. So if morning had comprehensive history & comprehensive exam, but moderate MDM and in the afternoon problem focused exam, but patient has additional complaints and you order further testing, call in a consult, etc, making the total MDM for the day high, you may bill as 99223.

 

[neena.kumar@gmail.com]

Thank you so much.