AmandaDumas
New
Hello all!
Would it be valid to report CPT 99499 - Unlisted Evaluation and Management service
WITH another CPT code 99202-99205 when a patient comes to the practice as an outpatient within 14 days of a hospital visit?
So if they were recently discharged from the hospital 3 days ago and see one of our providers in that time frame, can we bill for a 99204 AND a 99499 or 99214 AND a 99499 on the same date of service?
It doesn't make sense to me to bill this way but someone at the office is asking us Coders to do this. Does anyone have any literature on the topic that I can send to explain why I personally think it is a bad idea??
I have already read what I could but I can't find any information blatantly saying that we CANNOT do this.
If the provider is following up with a patient in an outpatient setting after they were recently discharged from the hospital, then the E/M 99202-99215 would fall under that service without the need for anything additional, in my opinion.
But I'm also waiting to hear back from the team to see if this request is coming directly from and insurance company as there was mention of insurance companies trying to improve on patient outcomes, post hospitalization.
Please advise! Thank you in advance. This one is interesting.
Would it be valid to report CPT 99499 - Unlisted Evaluation and Management service
WITH another CPT code 99202-99205 when a patient comes to the practice as an outpatient within 14 days of a hospital visit?
So if they were recently discharged from the hospital 3 days ago and see one of our providers in that time frame, can we bill for a 99204 AND a 99499 or 99214 AND a 99499 on the same date of service?
It doesn't make sense to me to bill this way but someone at the office is asking us Coders to do this. Does anyone have any literature on the topic that I can send to explain why I personally think it is a bad idea??
I have already read what I could but I can't find any information blatantly saying that we CANNOT do this.
If the provider is following up with a patient in an outpatient setting after they were recently discharged from the hospital, then the E/M 99202-99215 would fall under that service without the need for anything additional, in my opinion.
But I'm also waiting to hear back from the team to see if this request is coming directly from and insurance company as there was mention of insurance companies trying to improve on patient outcomes, post hospitalization.
Please advise! Thank you in advance. This one is interesting.
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