AAPC - Back to school
Results 1 to 4 of 4

Thread: Office visit and admit same day

  1. #1

    Default Office visit and admit same day

    AAPC: Back to School
    In the event that a provider sees the patient in the clinic, decides to admit the patient to the hospital, and another provider from the same specialty assigned to the hospital has the face-to-face encounter with the patient that day, can the initial provider whom does not carry out the face to face portion bill for the admit (99221-99223) as he is doing all of the work-up?

    The confusion lies with Medicare viewing each specialty as a single provider, so only one provider can bill that day, but we are unable to find any reference specifically stating that the initial provider has to have the face to face visit with the patient in the hospital as opposed to the partner at the hospital.
    Any insight would be greatly appreciated.

  2. #2


    Whoever admitted the patient would bill for the admit H & P - 99221-99223. Is the provider of the same specialty in the same group?

  3. #3


    The doctor in the clinic did all of the documentation, a full history, exam etc. and decided to admit the patient that day for treatment. The doctor already in the hospital is from the same group and same specialty. Our clinic is attached to our hospital by the way.
    Last edited by kemptar; 10-08-2008 at 10:29 AM. Reason: adding more info

  4. #4


    Whoever put the orders in for admission and did the admit H&P bills for the admit. You won't get paid the visit in the clinic. The physician in your group who say the patient subsequent to the admission, but same calender day, won't get paid the subsequent visit since it's the same group, same patient, same day, same diagnosis? you could try to appeal it, most carriers will deny. Good luck!

Similar Threads

  1. office visit and admit same day
    By la_0922 in forum E/M
    Replies: 1
    Last Post: 07-12-2013, 11:12 AM
  2. Office visit and admit
    By carol52 in forum E/M
    Replies: 2
    Last Post: 01-23-2013, 11:32 AM
  3. Office procedure same day as admit
    By Deb2009 in forum Medical Coding General Discussion
    Replies: 0
    Last Post: 05-12-2011, 11:59 AM
  4. office visit then admit
    By renifejn in forum E/M
    Replies: 1
    Last Post: 11-22-2008, 05:46 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.