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Pulmonology Coding Alert

READER QUESTIONS :

Identify Split Visits by Spotting Shared Effort

Published on Tue Mar 24, 2009

Question: A 78-year-old established Medicare patient suffering from chronic obstructive pulmonary disease (COPD) and asthma is admitted to the hospital as an inpatient for acute exacerbation. The next day, a fully licensed nonphysician practitioner (NPP) performs an expanded problem-focused history and an expanded problem-focused exam to check the patient's condition.About four hours later, the pulmonologist meets with the patient, evaluates the patient's pulmonary function tests and performs a brief pulmonary exam. Is this a shared visit? Maine Subscriber Answer: This E/M may qualify for shared/split visit billing, but you must satisfy Medicare's specific documentation guidelines for the claim. Report the following codes: • 99232 (Subsequent hospital care, per day, for the evaluation and management of a patient, which requires at least 2 of these 3 key components:an expanded problem focused interval history; an expanded problem focused examination; medical decision making of moderate complexity ...) for the E/M • 493.22 (Chronic [...]
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