# 99231-99233 Inpatient Hospital Visits



## minoweka (Apr 5, 2013)

One of the section notes on 99221-99233 states:

EXCLUDES: Inpatient E&M services provided by other than the admitting physician (99231-99233)

That is exactly what is occuring.

We are receiving payment from MediCal and then they come back and recoup stating "submission/billing error" when billing 99232.

The physician's providing the services that are getting paid and then recouped belong to the same physician group (same tax id #) as the admitting physician.

Must the physician be the actual admitting physician or should I appeal because same tax ID#?


Thank you 
Dorothy


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## rda23@aol.com (Apr 5, 2013)

It sounds as if you are billing this correctly; the CPT guidelines indicate that post-admission work by physcians other than the admitting physician should be treated as Subsequent Care (99231-33) or Consulations (99251-55).  I'd pursue the Tax ID angle -- and it might be worth asking if that's creating other transfer-of-care complexities.


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## OCD_coder (Apr 8, 2013)

If the physicians are of the same group and are NOT subspecialists you can only bill one E&M per DOS.


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## minoweka (Apr 9, 2013)

Thank you for these insights. I appreciate it.


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