Wiki Subsequent visits for hospitalist

[beulah.price]

According to CMS guidelines, can you charge for more than 1 hospitalist visit per day? Example a hospitalist sees a patient at 10:00 am and a different hospitalist sees the same patient at 10:00 pm. Can both charge a subsequent hospital visit?

 

[mhstrauss]

According to CMS guidelines, can you charge for more than 1 hospitalist visit per day? Example a hospitalist sees a patient at 10:00 am and a different hospitalist sees the same patient at 10:00 pm. Can both charge a subsequent hospital visit?

The Subsequent Hospital Care codes 99231-99233 are "per day", so you can only bill 1. You can combine all documentation from both hospitalists together for a possible higher level of service.

 

[CPC CEMC]

Subsequent Visits for Hospitalists

I agree with the previous post!

Also, physicians in the same group practice who are in the same specialty must bill and be paid as though they were a single physician. If more than one E/M (face-to-face) service is provided on the same day, to the same patient by the same physician or more than one physician in the same specialty in the same group, only one E/M service may be reported unless the E/M services are for unrelated problems.

Physicians in the same group practice but who are in different specialties may bill and be paid without regard to their membership in the same group.

If more than one physician in the same group practice with the same specialty bills for an E/M on the same day for the same patient, it may result in a denial of one of the E/M services. In this instance, an appeal of the denied E/M service will be necessary to provide supporting documentation of an unrelated service or a physician sub-specialty not reflected in the Medicare provider record.

Reference: Centers for Medicare and Medicaid Services Claims Processing Manual, Publication 100-04, Chapter 12, section 30.6.5