Internal Medicine Coding Alert

Question: Dr. Smith was on-call and admitted a patient to the hospital. On the same day, Dr. Jones took over as the on-call physician. He saw the patient and discharged her that day. Because we admitted and discharged the patient on the same day, which physician should report 99235?

Pennsylvania Subscriber

Answer: Because Dr. Jones saw the patient and Dr. Smith did not, only Dr. Jones should bill 99235 (Observation or inpatient hospital care, for the evaluation and management of a patient including admission and discharge on the same date ...).

You can report 99235 only if the physician actually sees and examines the patient. Because Dr. Smith only admitted the patient, he cannot report the E/M code.