Results 1 to 4 of 4

H&P & Discharge help

  1. #1
    Question H&P & Discharge help
    Medical Coding Books
    I was hoping to get some help with this scenerio:

    Dr. Podiatry has an established patient that needs sx. Dr. General ortho does an H&P in the hospital on the same date of sx and then does the discharge the following day. Both MDs are from the same practice billing under the same tax id. I've been told that because they are different sub specialties that this can be billed seperately. I don't think this is correct and was hoping to get some guidance with this. If this is not correct then Dr. General ortho will want documentation to prove it. Can anyone point me to where I might find documentation to show her? (if she's not able to bill this)
    Thanks in advance!
    Cathy

  2. #2
    Default
    look in the medicare claims processing manual chapter 12 on page 33 or (30.6.5)
    the same tax ID has nothing to do with it if they are truely different specialties. i work for a multi-group practice all with the same tax ID but differnt specialties. sorry i cant find the direct link if i do i'll reply again
    good luck
    chris, CPC

  3. #3
    Default
    Quote Originally Posted by cbheusman View Post
    I was hoping to get some help with this scenerio:

    Dr. Podiatry has an established patient that needs sx. Dr. General ortho does an H&P in the hospital on the same date of sx and then does the discharge the following day. Both MDs are from the same practice billing under the same tax id. I've been told that because they are different sub specialties that this can be billed seperately. I don't think this is correct and was hoping to get some guidance with this. If this is not correct then Dr. General ortho will want documentation to prove it. Can anyone point me to where I might find documentation to show her? (if she's not able to bill this)
    Thanks in advance!
    Cathy
    I've actually had this situation arise, and the same tax id should not be an issue, you may have to appeal the decision at first which is what we have had to do but once we specify that both Md's are of differant sub-specialties it usually fixes the problem, also make sure that your not using the same diagnosis for both physicians make sure they are using distinctive dx for both since one is using their "sub-speciality".

    Don't be discouraged if it is denied initially, just have your documentation ready just in case.
    Roxanne Thames CPC, CPC-I, CEMC
    rthamescpci@gmail.com


    "Remember the greatest gift is not found in the store but in the heart of true friends"

  4. #4
    Default
    Chris & Roxanne,
    Thank you so much for your responses! The podiatrist we are billing for just joined the group and I have not had to bill for one before. I don't mind having to appeal a denial as long as I know for sure I have billed it correctly in the first place. With your responses I feel more comfortable billing this out.
    Thanks again!
    Cathy

Similar Threads

  1. discharge 99238 & 99239
    By rcbaker in forum Pediatrics
    Replies: 5
    Last Post: 01-28-2014, 08:44 AM
  2. Discharge & Readmission same DOS
    By Erica1217 in forum E/M
    Replies: 5
    Last Post: 05-10-2012, 08:33 AM
  3. Admin & Discharge same day
    By krist in forum Modifiers
    Replies: 1
    Last Post: 02-13-2012, 06:54 AM
  4. E&M Discharge and re-admit codes
    By smithdk01 in forum E/M
    Replies: 0
    Last Post: 02-16-2010, 10:42 AM
  5. Cardioversion & Discharge
    By dpumford in forum Cardiology
    Replies: 3
    Last Post: 07-27-2009, 11:52 AM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •  
Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?

Login

Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.