Results 1 to 4 of 4

Mod for hospital visit

  1. #1
    Prescott, AZ
    Cool Mod for hospital visit
    Medical Coding Books
    I have billed out hospital charges for a patient seen on the same day but two seperate hospitals.

    hospital #1 -- 99291 w/resp failure, documented time of 70 minutes

    Hospital #2 -- 99223, patient was ICU, but physician chose to code as 99223.

    Medicare has denied pmt for 99223, as can't bill this code same day as a 99291. After calling Medicare to explain that charges were for 2 seperate hospitals, they suggested a modifier may possibly be used. It's not bundled, so a Mod 59 will not work. Any suggestions???
    Tracy L. Wood, CPC

  2. #2
    I've always used a modifer 25 on my hospital visits if I am billing critical care as well.
    Melissa Tescher, CPC, CPMA, CEMC Compliance and Coding Specialist
    Willamette Valley Professional Services member National Advisory Board 2013-2015

  3. #3
    please let me know whether the physician is the same?

  4. #4
    Prescott, AZ
    Yes, same physician, same patient, two different hospitals
    Tracy L. Wood, CPC

Similar Threads

  1. Office visit E/M using MOD -25
    By KaitlynEFitch in forum E/M
    Replies: 1
    Last Post: 06-24-2014, 08:58 AM
  2. Mod -25 with an ED visit
    By pmogel in forum Modifiers
    Replies: 3
    Last Post: 04-02-2014, 07:45 AM
  3. mod 55 for all post op or one visit?
    By zoolug in forum Modifiers
    Replies: 2
    Last Post: 02-18-2013, 11:38 AM
  4. Mod? for Ob observation visit
    By cnramsey in forum Medical Coding General Discussion
    Replies: 0
    Last Post: 02-10-2010, 12:50 PM
  5. Replies: 3
    Last Post: 02-05-2010, 09:12 PM

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?


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.