Wiki Initial and Subsequent Hospital Visits Same Day

[Cherish79]

Good afternoon all! I had one of my providers ask me if it would be appropriate to bill both an initial hospital visit and a subsequent hospital visit on the same day. I said no, but I thought, after reading in the CPT book the additional notes for these 2 groups of codes, that I would make sure that is correct. I know this is probably a really stupid question, but you know how it is when you think you know something, then you start questioning it!

Thanks!

 

[OCD_coder]

No, one E/M per DOS. The physician can see that patient multiple times during the day and document it appropriately. All of the information can be used to determine the level.

The only time you can bill two E/M's on the same is when the physician does rounds in the morning and the level is somewhere between a 99231 and 99233. Then the patient can go critical later in the day. A modifier 25 is applied to the Critical Care E/M codes. Criticial Care is time based and condition of the patient based. Thus allowing for this particular scenario. If the situation is reveresed, then only the critical care E/M's are billed. Time can be accrued through out the day.