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Cardiology Coding Alert

READER QUESTIONS:

Same Specialty, Same Day, Don't Code

Published on Wed Feb 16, 2005

Question: We have a "moonlighter" cardiologist who will admit a patient at 2 a.m. for one of the doctors off-call, and when that doctor returns to call at 7 a.m., he will then go see his patient. The first cardiologist reported an admit and consult. Since this is technically the same day, what should the second cardiologist bill?


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Answer: If both cardiologists are in the same group and visit the patient for the same diagnosis, the second physician cannot submit a claim. The rules state that you cannot report for the same specialty on the same day for the same patient. CPT illustrates that the code definitions for the admit codes (99221-99223) are "per day." In other words, these codes include all of the care provided on that calendar date.
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