kfrycpc
Guest
deleted
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Wiki Resident vs. Physician
- Thread starter kfrycpc
- Start date
OCD_coder
True Blue
It does not sound like the teaching physician was there when the resident saw the patient on the admit date, which is a requirement per the Teaching Guidelines.
The admit service does not need to occur on the exact date the patient is admitted, in this case the teaching provider saw the patient on Day #2-4/29 and as long as the documentation by the teaching provider supports the 99222 the work the resident performed on the previous date cannot be used or reported. Based on my experience with Teaching Physicians they will not document a complete note. See and agree = no fee as we could not use documentation performed on a previous day for a different date of service, all three components will need to be documented.
Teaching Physician
A physician, other than an intern or resident, who involves residents in the care of his or her patients. Generally, for the service to be payable under the Medicare PFS, he or she must be present during all critical or key portions of the procedure and immediately available to furnish services during the entire service.
http://www.cms.gov/Outreach-and-Edu...roducts/downloads/gdelinesteachgresfctsht.pdf
The admit service does not need to occur on the exact date the patient is admitted, in this case the teaching provider saw the patient on Day #2-4/29 and as long as the documentation by the teaching provider supports the 99222 the work the resident performed on the previous date cannot be used or reported. Based on my experience with Teaching Physicians they will not document a complete note. See and agree = no fee as we could not use documentation performed on a previous day for a different date of service, all three components will need to be documented.
Teaching Physician
A physician, other than an intern or resident, who involves residents in the care of his or her patients. Generally, for the service to be payable under the Medicare PFS, he or she must be present during all critical or key portions of the procedure and immediately available to furnish services during the entire service.
http://www.cms.gov/Outreach-and-Edu...roducts/downloads/gdelinesteachgresfctsht.pdf
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mhstrauss
True Blue
The physician's "Initial Inpatient Care" does not have to match the facility's admit date. You should use the date that the physician actually performed the initial service.
kfrycpc
Guest
So you are saying I should use the date the resident performed the H&P even though the physician has on the billing card a different date?
kfrycpc
Guest
..,,,
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mitchellde
True Blue
I realize you deleted the thread as you believe no one knows the answer. The correct answer was already provided which is the physician cannot bill for the resident service if the physician was not physically present during the visit and provided part of the documentation. The following link which is the same one provided in the earlier post will assist
www.cms.gov/Outreach-and-Education/.../gdelinesteachgresfctsht.pdf
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