jdibble
True Blue
I have a question about the use of the Prolonged Services codes if someone could help...
One of my Hospitalists is billing for a 99356 and the billing company sent back an inquiry stating that the insurance denied the charge because there is no "sub care" billed. I looked into the notes, and apparently the patient was seen early in the morning and admitted by another Hospitalist and then this physician saw the patient for continued care later that morning. The admit doc billed 99222 and then the second doc billed for the prolonged charge both under the same tax ID.
My question is, to bill for the prolonged services would both visits have to be done by the same physician or could it be another doc from the same group? Hopefully someone can clear up this confusion for me - I will be meeting with the Hospitalists tomorrow and I would like to have this issue presented to them so they know how to apply this charge in the future.
Thanks for the help.
One of my Hospitalists is billing for a 99356 and the billing company sent back an inquiry stating that the insurance denied the charge because there is no "sub care" billed. I looked into the notes, and apparently the patient was seen early in the morning and admitted by another Hospitalist and then this physician saw the patient for continued care later that morning. The admit doc billed 99222 and then the second doc billed for the prolonged charge both under the same tax ID.
My question is, to bill for the prolonged services would both visits have to be done by the same physician or could it be another doc from the same group? Hopefully someone can clear up this confusion for me - I will be meeting with the Hospitalists tomorrow and I would like to have this issue presented to them so they know how to apply this charge in the future.
Thanks for the help.
