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Thread: Assistance Please

  1. #1
    Join Date
    Apr 2007

    Question Assistance Please

    AAPC: Back to School
    Does this makes any sense to anyone?

    This was something passed on to me regarding subsequent visits.

    Normally with keying, we do not enter two charges in one day unless it was prolonged care, CC or significant change in the DX with code 233. The physician that coded a regular subvisit will not be keyed into the system and only the admission would count.

    Well the Hospitalist that provided the subvisit care would like to know how can she be compensated for the time that she took to see and document (progress note) the patient's progress. Could you help clarify this for me so that I may pass it along to the Hospitalists

    If Dr. X admitted the pt at 2:00a and Dr. Y arrived later that day and saw the pt as a regular subvisit, we normally do not key the subvisit unless it was critical care, prolonged care or a significant change in the Dx with cpt 233

  2. #2
    Join Date
    Apr 2007


    Is Dr. Y a part of your Group? Is Dr. X or Dr. Y a Specialist?

  3. #3
    Join Date
    Apr 2007


    I believe they are in the same group.

  4. #4
    Join Date
    Apr 2007
    Milwaukee WI

    Default It's just good medical practice

    You can only have one E/M on the day of admission, unless the patient becomes critically ill. Or ... if you have sufficient time to code as prolonged service. Two doctors of the same specialty in the same practice are considered to be the "same doctor" as far as billing is concerned. That's why Dr Y's services cannot be separately billed.

    The best way to explain it is that it is good medical practice, and that in the long run it "comes out in the wash." That is, there will be times when Dr Y codes the admit at 2:00a and Dr X can't code anything for the subvisit later the same calendar date.

    If your physician's compensation is tied to RVUs, however, perhaps your billing office can institute a "dummy" code that would credit the RVUs for the work done, but not generate a bill.

    I hope that helps.

    F Tessa Bartels, CPC, CEMC

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