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E/M initial for patient who was transferred

  1. #1
    Default E/M initial for patient who was transferred
    Medical Coding Books
    A patient is inpatient for a week at Hospital A. Her physician orders her to be tranferred to a different hospital that is better capable to handle her required tests and treatment.
    That same physician charges an initial hospital visit (99222-25) at Hospital B on the same date as as he charges a subsequent hospital visit (99232) at Hospital A prior to the transfer.

    this is unbundled/ duplicate, isn't it?

    should/could he have just billed subsequent (99232) on day 2 at Hospital B and nothing on day 1 at hospital B?

  2. #2
    Yes that is dup billing, but why is your doctor charging initial consult at Hospital B if the patient was transferred by the same doc. I believe you just transfered the care not a new consult/correct me if I am wrong


  3. #3
    I will have to say, I have never seen this one done before. Very inventive, not correct, but inventive.

    He only gets the subsequent care day, admit was already done, sorry he had to fill out additional paperwork for the new facility but you'll have that sometimes. Doesn't really matter which hospital the subsequent day is charged from (on the day of transfer) because he only gets to charge it once a day no matter how many times he physicially sees the patient.

    Laura, CPC, CEMC

  4. #4
    thank you so much for your input. I appreciate the support. we also found out this morning that the hospital B E/M visit documentation used the H&P from 2 days prior done in hospital A. - seemingly further proof that the provider did not actually deserve payment for a new visit E/M. thanks again, JaneneH, CPC

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