First question - are both physicians in the same specialty and group practice?
Second question - is this "second" visit on the same DOS medically necessary?
Third question - is time documented for the second visit, and is that time 30 minutes or more?
If the answer to ALL questions is YES ... You can use the prolonged service codes. HOWEVER ... you will have to bill both the initial hospital visit and the prolonged service code on the same claim and under the same physician name/NPI. We would send the bill out under the name of the physician who did the initial visit.
Hope that helps.
F Tessa Bartels, CPC, CEMC
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