Eli's Rehab Report

Question: The physiatrist I work for visited a stroke patient in the neurological unit of the hospital. Later that day, a different physician transferred the patient to the rehabilitation unit. My physiatrist visited the patient there that evening. Can I bill for both visits on the same day?

Ohio Subscriber

Answer: Its not clear from your question whether the rehabilitation unit is in the same hospital, or whether the patient is still considered inpatient status. Normally, when two E/M services are performed on the same date in the same facility, only one E/M code can be billed. CPT instructs physicians to carry over the work from the previous site to the new one. Therefore, you would combine the documentation from both the inpatient visit and the rehabilitation visit to determine the level of history, exam and medical decision-making, and determine the appropriate E/M code.

The only exception to this carry over principle is when a patient is discharged from acute care and admitted to a separate nursing facility on the same day. In that situation, the physician can bill for a visit at the hospital as well as the 99303 (comprehensive nursing facility assessment) on the same date.