Wiki Can 99291 and 99238 bill together?

[AmandaW]

If the Dr. in an inpatient setting performs critical care in the morning, then patient is discharged to another hospital later that day, can that Dr. bill for both? The critical care and discharge on the same day?

 

[antburns2]

2 99xxx services on the same DOS should always lead to consideration of documentation support above and beyond the requirements for each individual code submission to append modifier -25, but I could not find a CCI or ME edit in the CMS physicians list that prohibits the submission of both for the same DOS.

A Burns RN BSN, CPC, CPC-H, CPMA
ClaimAudit LLC

 

[AmandaW]

Thank you much! Me neither.

 

[JDHumenay]

I'm sure this has already been tackled, but the CPT book plainly states that the 99238-99239 codes "are to be utilized to report all services provided to a patient on the date of discharge..."
I don't see a way around it. I would have gone with the 99239 (assuming the MD documented time spent doing the critical care in the AM).

Is there another guideline I'm overlooking? I'm struggling w/ this issue as well.
Thanks!

 

[Dr archana dadhich]

One provider can assign one EM code per day.if critical care done by different provider then we can bill both.otherwise code only 99238.
regards
Dr Archana