Wiki prolonged care question

[Denise M]

If two physicians in the same group see an inpatient with one of them doing prolonged care do they need to combine the work or can one bill lets say 99223 and the other bill the 99356??

I have looked all over the Medicare site and MLN articles but it is not specific enough. Not sure if work has to be combined and billed under one doctor or if two separate claims for each doctor can be billed.

I know with critical care you can bill individually now but it does not say anything about prolonged care?

Please help,

Thank you!

 

[nrichard]

This ends up as split/shared visit.
https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/downloads/R1875CP.pdf
Only one E&M level can be billed per day, per tax ID. Combine your times for each MD. (I would bill it under the physician that initiated care). Select new appropriate 9922X code, with 99356 (you may be able to bille 99357 too).

 

[Denise M]

Thank you!