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place of service / type of E/M to use

  1. Default place of service / type of E/M to use
    Medical Coding Books
    I have a strange scenario, any advice on how to code and bill this is greatly appreciated:

    Small town hospital that has an attached OP clinic as well as an attached office visit clinic that this physician works at.

    Scenario 1: Patient is an IP at the hospital. They wheeled the patient down to the physicians office so the physician could see the patient (physician didn't want to leave his office and since the hospital is right down the hall they brought the patient to him). The physician did x-rays in his office (he owns the equipment and does the interpretation) and he dictated the progress note in the hospital chart. This is basically a subsequent IP visit except they brought the patient to the physician, instead of the physician going to the patient.

    Scenario 2: Pateint is an IP at the hospital. They wheeled the patient down to the OP clinic and the physician saw the patient and dictated a progress note in the hospital chart.

    Does the location of the visit matter in these situations or would they just bill the 9923x with a POS 21 even though the actual visit took place at a POS 11 and POS 22? What about the xrays?

    thanks in advance for any help and/or opinions.

  2. #2
    Wow I would believe that still needs to be billed as an Inpatient visit with POS as Inpatient. Like to see what overs think.
    Herbie W Lorona Jr., CPC, CPC-H

  3. Default
    The physician can not bill for an OP visit which is why he wrote a progress note in order to charge for a subsequent hospital visit or 992xx based on the info you provided. The only other code he can bill for this admitted patient would be for a consult if the patient was referred by his admitting hospital provider to your doctor for a consult by a specialist. As far as the X-Rays go, he may have to eat that charge for the simple fact that since he owns the equipment and not the hospital where the patient was admitted.

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