outpatient visit at 2nd hospital while inpatient at 1st hospital

stacigadsby

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is there any way to get paid for an outpatient consult at hospital #2 while patient is admitted at hospital #1?

patient is an inpatient at hospital #1, they transport her over to hospital #2 to see a radiation oncologist as an outpatient, then transport her back to hospital #1 and discharge her the next day. Medicare wants their money back for OP visit since patient was IP at the time.\

is there any modifier or special code or something to get the OP visit doctor paid?

thanks.
 

lisa 18

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Outpatient is bundled into the inpatient

Medicare is correct in asking for their money back. The patient was inpatient even though they saw a radiologist in another hospital. The outpatient service would be bundled into the hospital charges.
 

thomas7331

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Your provider should be able to bill an inpatient consult for the professional services. But the previous post is correct that any facility or office expenses would be included in the hospital's inpatient reimbursement. If your clinic incurred any technical costs for the use of your facility, you can bill those by invoice to the hospital where the patient was admitted.
 
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