Wiki Just venting about Provider not able to get credit for work

Create Wiki
K

KMoose

New
Messages
7
Location
Stoughton, WI
Best answers
0
just a bit irked on behalf of my provider who drives to the hospital to do follow-up visit on inpatient. But patient is not in room due to testing being done elsewhere in the hospital. The provider spends time reading the files, coordinating care with other provider, personally viewing images...documents all of this, including a time statement in their note. But since they didn't actually spend any face-to-face time with the patient it doesn't "count". Don't get me wrong, I'm not irked at the patient, just that our providers don't get credit for all the work they do behind the scenes.

Ah well, vent over. :cool:
 
Face to face time is required for office visits, but for hospital visits, the requirement is 'floor time'. Why are they not getting credit for this, especially if they have a time statement in their note? Coordination of care, as you've stated, would be valid for billing if it constitutes more than 50% of the time on the floor.
 
That's what our compliance person says. "They must be seen face to face." I pressed the point on exactly the line stating "floor time" and lost. Looked all over online to try to find it spelled out if face to face time was necessary for a follow up hospital visit and couldn't find anything to support either side.
 
Last edited:
The subsequent hospital care E&M codes in the CPT book says "Typically, __ minutes are spent at the bedside and on the patient's hospital floor or unit." So I would think that if work was done on the patient's behalf in their unit, and it's documented, then it should be reimbursable.
 
You must log in or register to reply here.
Top