Wiki new biller

[pattygwood42@yahoo.com]

When a patient is a inpatient hospital and is brought to a private ophth for an exam in the same facility what place of service and cpt codes do I use

 

[AlaskanCoder]

Payers won't cover an outpatient exam during an inpatient stay. The patient's status was inpatient, so the exam would be an in-patient exam with POS 21. The CPT code would be determined by the documentation, most likely an E&M code. Any testing done outside of a normal ophthalmological exam (i.e. imaging, visual field exam, etc.) would be inclusive to the inpatient stay and would not be billable by the private practice. If this was a requirement of the facility, i.e. the facility does not own the necessary equipment for the testing, the private practice should have an agreement with the facility to contract the use of the equipment for the testing.