Wiki Mod for hospital visit

[tlwhlw]

I have billed out hospital charges for a patient seen on the same day but two seperate hospitals.

hospital #1 -- 99291 w/resp failure, documented time of 70 minutes

Hospital #2 -- 99223, patient was ICU, but physician chose to code as 99223.

Medicare has denied pmt for 99223, as can't bill this code same day as a 99291. After calling Medicare to explain that charges were for 2 seperate hospitals, they suggested a modifier may possibly be used. It's not bundled, so a Mod 59 will not work. Any suggestions???

 

[missy874]

I've always used a modifer 25 on my hospital visits if I am billing critical care as well.
99223.25
99291

 

[raghu.kurna]

please let me know whether the physician is the same?

 

[tlwhlw]

Yes, same physician, same patient, two different hospitals