Forum - Questions & Answers

Aug 28th, 2009 - tamarah

99235

Is this code payable for two days in a row for a Medicare patient?

Aug 28th, 2009 -

If the documentation backs it up

Pt in ED, placed OPO in hospital, doc sees pt, sends home->99235. Next day pt back in ED, again put in hospital OPO, doc sees pt, sends home again->99235. Just be sure the second document is complete and does not just say "see prev H&P for details." The MAC will compare these codes the the hospital bill and see that they make sense.

Aug 31st, 2009 - Codapedia Editor 1,399 

99235

Is the patient in Observation two days in a row? In that case, this is not the correct code to use.

Use 99235 when the patient is admitted and discharged (inpatient or OBS status) in the same calendar date, and for Medicare, is in OBS for more than 8 hours. The physician must see the patient twice, for the admission and for the discharge. There must be two notes.

Can you expand on your situation?



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