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Hospital Coding Question

  1. #1
    Location
    Reading, PA
    Posts
    28
    Question Hospital Coding Question
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    Let me see if I can explain this so someone can understand.

    Patient goes through the ER (ER is billing for their services) then ER admits patient to our "DR A's" service (Internal Medicine).

    In the middle of the night, before our "DR A" is able to see the patient and do the initial evaluation on the patient, the patient then CODES and the hospitalist is called in to take care of the issue at hand.

    Now my question is, can the Hospitalist (not part of ER doctor and not part of DR A) bill for the service when he went in to the patient in the middle of the night (and what is the cpt)

    Can the Hospitalist bill for the supervision of the procedure to perform the CODE (the cardio paddles) also if the nurses on the floor have questions in the middle of the night and "DR A" didnt see the patient yet, can the hospitialist bill for reviewing the chart if additional meds or test are required (since this patient has been sent out of the ER and now in a room for admission and "DR A" still hasnt come into see the patient and it is 3am)

    I hope I explained myself in away to get some type of answer.

  2. #2
    Location
    Louisville, KY
    Posts
    1,101
    Default
    Sounds like the hospitalist should get critical care codes . . . assuming the record supports it.

  3. #3
    Default
    ditto from kev, also, the pos is 23-pt not admitted
    Quote Originally Posted by danatrimbur View Post
    Let me see if I can explain this so someone can understand.

    Patient goes through the ER (ER is billing for their services) then ER admits patient to our "DR A's" service (Internal Medicine).

    In the middle of the night, before our "DR A" is able to see the patient and do the initial evaluation on the patient, the patient then CODES and the hospitalist is called in to take care of the issue at hand.

    Now my question is, can the Hospitalist (not part of ER doctor and not part of DR A) bill for the service when he went in to the patient in the middle of the night (and what is the cpt)

    Can the Hospitalist bill for the supervision of the procedure to perform the CODE (the cardio paddles) also if the nurses on the floor have questions in the middle of the night and "DR A" didnt see the patient yet, can the hospitialist bill for reviewing the chart if additional meds or test are required (since this patient has been sent out of the ER and now in a room for admission and "DR A" still hasnt come into see the patient and it is 3am)

    I hope I explained myself in away to get some type of answer.
    Rachele Porter, AS, CPC, CPC-H, CEDC
    no weapons formed against me shall prosper

  4. #4
    Location
    Milwaukee WI
    Posts
    4,466
    Default 99291
    Probably critical care for hospitalist. Needs to document face-to-face time spent providing critical care for critically ill patient. In the inpatient setting, face-to-face time includes floor/unit time spent reviewing charts, etc. If total time (doesn't have to be continguous, but cumulative) is 75 minutes or more would bill 99291 and 99292.

    If also billing 92960 (cardioversion) or 92950 (CPR) you would add the -25 modifier to the E/M code(s).

    Hope that helps.
    F Tessa Bartels, CPC, CPC-E/M

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