Wiki OBS consult, admitted next day by same doc

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brandyleigh23

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I have a patient that was consulted by Cardiology because she had a pacemaker placed on that day. Everything went well and patient was stable. She was seen again the next day by the same cardiologist and then admitted by him for pacer malfunctions. How does the doc get paid for his services? Do I just bill for the admit?:confused:
 
clarity

Your statement " I have a patient that was consulted by Cardiology because she had a pacemaker placed on that day. Everything went well and patient was stablé'' is not clear if you can give some more details , this might be answered.

Thanks.
 
To clarify, here are the shortened versions of the reports:

#1

DATE OF CONSULTATION: 07/11/2012

REQUESTING PHYSICIAN: Dr. "Surgeon"

REASON FOR CONSULT: Status post pacemaker placement

HISTORY OF PRESENT ILLNESS: Ms. "Patient" is a 52-year-old female who has had pacemaker since 1985. She states she had gentle third-degree heart block that was found while she was pregnant by Holter monitor. Patient states that the lead has been fractured and she has been pacing her chest. The patient was taken to the OR today by Dr. "Surgeon" and underwent placement of a right-sided dual chamber permanent pacemaker and removal of the left-sided pacemaker. Cardiology is now being consulted.

ROS:

*
*
*
ASSESMENT: Status post placement of right-sided dual chamber permanent pacemaker with removal of left-sided pacemaker.

PLAN: Continue current medications. Patient will followup with her cardiologist in Raleigh.

signed, Dr. "Cardio"


#2

DATE OF ADMISSION: 07/12/2012

REASON FOR ADMISSION: Palpitations after recent surgery.

HISTORY OF PRESENT ILLNESS: Ms. "Patient" is a 52-year-old female patient who just underwent surgery on 07/11/2012 for malfunctioning pacemaker electrode. At that time, she underwent placement of a right-sided dual-chamber pacemaker with removal of the left-sided pacemaker, which was done by Dr. "Surgeon". The patient comes into the emergency room at this time with complaints of "twiching" at the chest. She points beneath the right breast. It appears at this time that the atrial lead may be dislodged. She will now be admitted for further workup.

ROS:
*
*
*
ASSESMENT AND PLAN:
1. The patient presents with twiching in the chest. she points beneath the right breast. It appears that she may be pacing the diaphragm. Pacemaker to be evaluated in the emergency room. It could also be that there is lead dislodgement. We will awaitfor the pacemaker to be interroogated.
2. Other diagnosis is history of hypothyroidism.
3. Treatment to be based on her findings. We will continue to follow.

signed, Dr. "Cardio"
 
If I understand what you are asking correctly, there's no problem billing both for the consult on the previous day and the admit on the day after. It would only be a problem to bill both services if they were done on the same DOS.
Hope this helps!
 
Based on the Note:

On 07/11 Dr Surgeon will bill 33228 with POS 21, and the Dr cardio will bill 9922x if it is medicare patient , if not the consultation codes 99241 - 99255 with POS xx.

on 07/12 Dr surgeon will bill 9928x with POS 23( emergency room Hispital) and Dr cardio will bill in patient hospital consultation as the patient is being admitted.


I hope this will give some idea to some extent.

Naveen Rachagolla
Client Policy Configuration Analyst.
 
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