Forum - Questions & Answers
Code for sending patient to the hospital
Is there a CPT®, ICD-9, or Modifier that indicates a PCP sent pt to the hospital? We have had a crazy couple of weeks where several patients have had to be sent to the hospital. Is this something we can document by code?
re: Code for sending patient to the hospital
nope. you either bill for the office visit or the hospital admission for that day. The "craziness" usually means a high level visit- 99215 in the office
re: Code for sending patient to the hospital
I agree with signaturedoc. If your physician or your physician's partner admits the patient, bill for the admission, not the o.v.
If your group isn't the admitting group, bill for the E/M service. It is often high complexity MDM. To bill a 99215 you need either a comprehensive history or comprehensive exam. The exam is usually easier to meet.