Wiki Two Providers bill 99220 for same dos

[jeremybcabarloc]

Hello all,

I was wondering what to do if two providers billed a 99220 for the same dos. However, one provider's specialty is cardiology and the other is internal medicine. Which should get paid and why?

 

[thomas7331]

Only the admitting physician/provider who orders the observation care should be using this code. Consulting physicians need to use outpatient and/or consultation codes 99201-99215 or 99241-99245 (depending on the payer). See MLN Matters # 7405: "All other physicians who furnish consultations or additional evaluations or services while the patient is receiving hospital outpatient observation services must bill the appropriate outpatient service codes."

Thomas Field, CPC, CEMC

 

[jeremybcabarloc]

Thank you so much for your response. This information will help me a lot. I come across this issue quite a bit. Thank you, Jeremy