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Wiki Pam Drgos, CPC

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pdrgos

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Palm Coast, FL
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What would you if your cardiologist said to bill all hospital consults as initial high (99223) only across the board? I do not agree.
 
Unfortunately, we can only code what is supported by documentation and medical necessity. All of our docs would like us to code high levels.
 
I can understand the why for financial reasons, but he feels all consults should be supported with a high admit. I disagree, if it does not have comp hist. and exam w/ high decision making, we should code lower. thanks!
 
You are correct. Stand your ground. Let him know that coding all high levels regardless of documentation is not ethical as well as extremely dangerous. Neither of you wants to end up on the OIG list unable to work in a medical facility or in the medical field, with fines and possible jail time. High productivity is just not worth the risk.
 
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