Wiki Initial Hosp care for an established patient

[krotroff]

I have a Nephrologist seeing a patient in the hospital for initial hospital care but he has seen the patitent for outpatient and dialysis services. Is the treatment for ESRD considered a new dx in the initial hospital visit or is it an established dx? I'm auditing notes and I have looked for this issue and I haven't found it addressed anywhere. Help!?

 

[amsmith]

Sorry I am late.

Have you found your answer? The RPA advises that this should be billed as Initial and established for non Medicare patients, but I cannot find the guideline. One person on here says that it should be established, but once again... there is no guideline to back it up. If you have it can you please guide me?