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Thread: Visit ?

  1. #1

    Default Visit ?

    AAPC: Back to School
    My doc's are question the following scenario and I'm not that experienced with E/M and would love your expertise.......I am think the 2nd physician should bill an initial hospital visit but I'm not 100% sure:

    Group physician 1:
    actually billed for an office consult and completed the admisson paperwork and orders although she is on the hospitalists service, so I think each subsequent visit is a hospital f/u.

    Group Physician:

    I saw blue cross patient that was seen by another physician in the office as an urgent add-on on Tuesday. The patient was admitted to a different physician that day and another physician in our Group was consulted that night. I saw the patient in the hospital the next day but only did a somewhat brief evaluation on her.

    How should I bill it? A consult, a follow up in patient visit?

    Physician that initially saw patient:

    I actually billed for an office consult and completed the admisson paperwork and orders although she is on the hospitalists service, so I think each subsequent visit is a hospital f/u.

    Your urgent assistance is most appreciated.....Thanks

  2. #2
    Join Date
    Apr 2007
    Milwaukee WI

    Default Same specialty, same practice?

    So both these physicians have the same specialty and are in the same practice?

    Your scenario is a little hazy to me, so I'm making some assumptions. Forgive me if I have it wrong.

    Day #1 ... patient seen in office by MD #1 then admited to hospital by MD #2. You would code ONLY the initial hospital visit (or initial observation), using BOTH sets of documentation to arrive at the appropriate level. I am ASSUMING that BOTH physicians actually saw the patient in person. You should have a policy in place in your practice that tells you who gets the credit (here it would be the person who saw the patient first).

    Day # 2 ... code for the documented subsequent hospital visit (or established patient office visit if patient is in observation status) - OR - discharge day management is patient is being sent home.

    Hope that helps.

    F Tessa Bartels, CPC, CEMC

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