OV during IP stay

[laurenstravach]

Patient was in Children's Specialized Hospital for 8 days. Child was transported from CSH to surgeon's office. HNJH denying surgeon's OV stating child was IP. Anyone know if there is a special modifier/code for this situation? Asked HNJH what service code CSH billed and I was told IP. They did not provide a service code. Thanks!

 

[thomas7331]

If the patient was inpatient status at the time of the service, you'll need to bill the hospital as place of service on your claim and use an inpatient E&M code in place of an office E&M code. So you'll need to look at the ranges 99221-99238 and 99251-99255 for your E&M codes in this case.