Wiki 99232 and 99233 same day

[coders_rock!]

Hello,

My doc is being denied for 99232.

Different Specialities,
Doc A: 99232
Doc B: 99223

Can these 2 e/m's be billed on the same DOS

 

[Emmy1260]

CPT guidelines under Initial Hospital Care:

"For initial inpatient encouters by physicians other than the admitting physician, see inital patient consultation codes (99251-99255) or subsequent hopstiat care codes (99231-99233) as appropriate."

 

[mitchellde]

since consults are an invalid service you are instructed by Medicare policy (adopted by most commercial) to bill a consult as an initial inpatient code. however the admitting physician must use an AI modifier on the initial visit for the admit. As long as these were different specialties and the admitting provider billed with the AI modifier, then there should be no problem, however if these are different specialties, then there should be different diagnosis for each of the encounters.