Colliemom
Expert
Asking for your advice on this matter
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Your physician has told you that on his hospital billing if he writes:
"new" and a dx - it is equal to a 99254, unless otherwise specified
"a check mark" and a dx - it is equal to a 99232, unless otherwise specified
"admit" and a dx - is equal to a 99223, unless otherwise specified
"New ER" and a dx - is equal to a 99244, unless otherwise specified
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If we were ever audited, would billing submitted in this method hold up in an audit?
Would an auditor take what level was billed, and then use the physician's documentation to substantiate the billing which would make the billing he submitted to the billing department irrelevant to the audit?
But it is a complicated issue, because I was also told by a few sources that a physician's billing is considered a legal document, and as such must be kept in case of audits. So by this reasoning then this is also a key factor in the audit.
(this is what the physician's billing would resemble)
Jane Doe, hospital medical record # 0000000, new, nausea and vomiting
(I would bill this a 99254 for nausea and vomiting, following the billing guidelines the physican provided above.)
_________________________________________________________
Your physician has told you that on his hospital billing if he writes:
"new" and a dx - it is equal to a 99254, unless otherwise specified
"a check mark" and a dx - it is equal to a 99232, unless otherwise specified
"admit" and a dx - is equal to a 99223, unless otherwise specified
"New ER" and a dx - is equal to a 99244, unless otherwise specified
_____________________________________________________________
If we were ever audited, would billing submitted in this method hold up in an audit?
Would an auditor take what level was billed, and then use the physician's documentation to substantiate the billing which would make the billing he submitted to the billing department irrelevant to the audit?
But it is a complicated issue, because I was also told by a few sources that a physician's billing is considered a legal document, and as such must be kept in case of audits. So by this reasoning then this is also a key factor in the audit.
(this is what the physician's billing would resemble)
Jane Doe, hospital medical record # 0000000, new, nausea and vomiting
(I would bill this a 99254 for nausea and vomiting, following the billing guidelines the physican provided above.)
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