Wiki Code 99203 vs 99213

[COSMAAPC]

One orthopedist treating patient and referred to another Ortho. in same
practice. We have been told if the 2nd ortho. has a speciality as the 2nd one
does, her speciality is Hands. That we should bill 99203 for first visit with
speciality. Cant find any answers to this question. bbishop@carolinaorthopedics.com

 

[Pat Liebl]

It both Doctors work for the same group you can only bill a new patient visit one time no matter what the specialty is!

 

[josephmglick]

Depends on the carrier and how the credentialling was done. Example: hand surgeon is crendentialed hand surgeon first/primary and ortho surgeon second/secondary with half or more than half of cases being hand cases. Again it'll depend on the carrier and their policy.

 

[kahodges]

If both doctors work for the same practice, *usually* 99203 can be billed only once per practice, then 99213 for any subsequent visits. However, I am with Joseph- I would check with the patient's insurance carrier first before billing.