Wiki CPT code 99232, 99233 being bundled with 99239 back in January 2020

Create Wiki
L

lmiller1

New
Messages
4
Best answers
0
Hi,

There was a bundling edit when using CPT code 99232 and 99233 with 99239 back in January of 2020. However, if you enter today's date and enter these codes there is no longer any bundling edits. We however are still getting denials in using 99232 with 99239, or 99233 with 99239. Am not sure why the edit is no longer there on AAPCs website when entering these codes as they are being still denied.

Please respond ASAP as I have sent 2 emails previously to this thread as I was told today that you do not respond to info@aapc.com.

Thanks,

Laurie Miller
 
Why are you billing subsequent hospital care, per day, WITH Hospital discharge day management.

It's either a discharge day or it's not a discharge day. You can't bill both.

And, for curiosities' sakes, what are they doing that they think should be billed as both hospital day management and discharge day management?
 
Yes, as Sharon stated you do not bill both for a follow up visit and discharge services on the same day.
I don't have my exact references available to quote, but I don't believe this is a CCI edit but rather a coding guideline or CMS claims processing rule. I assume by bundling edit, you mean CCI edit.
Basically, if you are the attending doctor doing discharge management, you would bill only 99238 or 99239 depending on the time spent. Any other clinician seeing the patient on the day of discharge would bill 99231-99233.
 
CMS directly addresses this issue here: CMS Manual System, Department of Health & Human Services (DHHS), Pub 100-04, Medicare Claims Processing Manual Chapter 12 - Physicians/Nonphysician Practitioners, 30.6.9.2 - Subsequent Hospital Visits and Hospital Discharge Day Management Services (Codes 99231 - 99239), C. Subsequent Hospital Visit and Discharge Management on Same Day

 
You must log in or register to reply here.
Top