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Thread: Decision for surgery - My orthopedist was asked to see a new

  1. #1

    Default Decision for surgery - My orthopedist was asked to see a new

    AAPC: Back to School
    My orthopedist was asked to see a new (to our practice!) Medicare patient in the hospital, admitted from the ER with a left femoral neck fracture. After evaluating the patient and writing a consult note to the hospitalist, he made the decision to do a hemiarthoplasty. I billed as follows:

    99232 (57)

    Medicare denied the 99232 saying it was included in the pre/post-opcare. Is 99232 the wrong code? Since she was a new patient to us, should I have used something different?

  2. #2
    Join Date
    Apr 2007
    Greater Pittsburgh


    why would you use a subsequent hospital care code, if the pt is new to you and a hospitalist admitted and requested your consult you would use 99222-57 (without an AI modifier for admitting the pt. the hospitalist would use the same 99222 with an AI modifier for the admission).
    jdemar, CPC, CMA

  3. #3


    I have been so confused about the 99222. THANK YOU for setting me straight !! You have no idea how much I appreciate it !!!!!

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