Lisa Bledsoe
True Blue
Does anyone know where I can find information about who can do an addendum to documentation? Specifically, can one provider do an addendum to another providers documentation?
Does anyone know where I can find information about who can do an addendum to documentation? Specifically, can one provider do an addendum to another providers documentation?
I did agree with you, Lisa, that the prior office visit couldn't be used and that there had to be documentation of a current or admitting E/M service. However, while researching another question for our business office, I found this gem in the Medicare Claim Processing Manual, Chapter 12, section 30.6.9.1:
"When a physician performs a visit that meets the definition of a Level 5 office visit several days prior to an admission and on the day of admission performs less than a comprehensive history and physical, he or she should report the office visit that reflects the services furnished and also report the lowest level initial hospital care code (i.e., code 99221) for the initial hospital admission. Contractors pay the office visit as billed and the Level 1 initial hospital care code."
Now, it would be nice to have a definition of "several days" (IMO, your 6 day time frame would count as that for me), but in your scenario, if the visit on 11/9/11 was a 99215, then with this as my proof, I would assign 99221 for the 11/15/11 admission. But if the doc is looking to use these key elements to assign 99222 or 99223, then Houston, we have a problem.
I did agree with you, Lisa, that the prior office visit couldn't be used and that there had to be documentation of a current or admitting E/M service. However, while researching another question for our business office, I found this gem in the Medicare Claim Processing Manual, Chapter 12, section 30.6.9.1:
"When a physician performs a visit that meets the definition of a Level 5 office visit several days prior to an admission and on the day of admission performs less than a comprehensive history and physical, he or she should report the office visit that reflects the services furnished and also report the lowest level initial hospital care code (i.e., code 99221) for the initial hospital admission. Contractors pay the office visit as billed and the Level 1 initial hospital care code."
Now, it would be nice to have a definition of "several days" (IMO, your 6 day time frame would count as that for me), but in your scenario, if the visit on 11/9/11 was a 99215, then with this as my proof, I would assign 99221 for the 11/15/11 admission. But if the doc is looking to use these key elements to assign 99222 or 99223, then Houston, we have a problem.
Do you think this would apply to the office visit documentation from one of the admitting physician's partners?