Oncology & Hematology Coding Alert

Question: Our patient is admitted through the ER by an ER physician who is not part of our practice. The hospital telephones our oncologist, receives orders, and the patient is admitted to the hospital under our physician. We are billing the admission date as the actual date our physician physically examines the patient. We bill nothing for the date orders are called in even though the patient is admitted under us and we are legally liable. Is this correct?

Georgia Subscriber

Answer: The initial hospital care codes, 99221-99223, are used to report the first hospital inpatient encounter (when the physician physically examines the patient) by the admitting physician. Therefore, your use of one of these codes is appropriate on that first visit, which, as you indicate, may or may not be the same as the day of admission.