Forum - Questions & Answers

Feb 1st, 2012 - ccox232003 1 

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?

Feb 1st, 2012 -

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

Feb 1st, 2012 - Codapedia Editor 1,399 

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.



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