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Physician seeing hospital consults in office?

  1. #1
    Default Physician seeing hospital consults in office?
    Medical Coding Books
    Our doctor is bringing some patients to the office from the hospital via wheelchair for consults ordered by other doctors. He is trying to save the time of going to the hospital by bringing the patient over to our office to see them.

    I know that I cannot bill them out as "place of service" = office because it will deny. He is doing the dictation over at the hospital as if he saw them there.

    Can I bill this out as under place of service "hospital" and cpt codes 99251-99255 even though he saw them in the office?

    Is this wrong?

    Rhonda Green, CPC

  2. Default
    Since this patient is considered "inpatient", you'll need to bill it as such. But by doing this, you're missing out on the facility portion of the charge. That's okay, if your provider doesn't mind that.


  3. #3
    Hi Rhonda,
    Something does not seem right with this situation. I don't understand why the doctor does not see the patient in the hospital if does dictation there anyway. Is your office in the hospital? To me it sounds like it isn't. Patient may get worse, infected, in an accident on the way to the office. If you are audited, they will think the doctor (and you) are trying to get over somehow. Is he is trying to get in more patients to make more money. If he is intentionally making the notes look like he saw the patients at the hospital and they were seen in the office, he is commiting fraud. Try posting the same question in the Evaluation and Management forum to see what they say. Please be very careful.


  4. #4
    We have two hospitals in our area, ours and another. Our hospital has a pediatric cardiologist whereas the other one does not. When premie patients are born at the other hospital and thought to have a cardiac problem they are tranferred here via ambulance for our cardiologist to evaluate them since he does not have a contract with the other hospital. Even though they are inpatient at the other hospital we do our billing as outpatient for physician's and facility. I bill for the physician's and questioned this scenario since i thought it should be inpatient and our facility compliance department explained to me that it would be just as if a patient were sent somewhere's for an outpatient MRI. I am not sure how the facility was affected by this but our E/M charges were paid and never denied. Hope this helps.

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