Wiki NP Billing 99223 after provider bills 99291

[toiwalker]

Can someone help me understand if a provider bills for critical care 99291, can an NP bill for a follow-up on the same day using 99233 subsequent visit?

 

[OCD_coder]

If they are in the same practice under the same Tax ID# , the answer is no. I'd have to review the whole situation and understand how your clinic was set up to determine the medical necessity of the two visits. Usually, the NP takes on the specialty of the provider they work with.

The 99291 takes the place of the 99223 the NP performed. Why was it necessary to do an additional H&P.

If the patient was admitted say at 1pm and the NP performed the H&P admit and then later in the day the patient went Critical and the MD/DO performed a distinctly separate service then they could be considered as reportable separately with a modifier on either one. We put the modifier 25 to establish that this service was performed after the initial H&P.

 

[toiwalker]

Thank you so much

 

[toiwalker]

I forgot to mention the claim was denying 99291 inclusive to total patient care.