Billing 99233

Patient is in critical care..Dr. Codes the visit 99233 for the two days he saw the patient. Other phys. Are seeing the same patient on the same level of 99233.

filed with the 99233 for my phys, ins comp rejected stating this:

m80: not covered when performed during the same session as a previously processed service for the patient.

please help.

re: BILLING 99233

There must be a medically necessary diagnosis code for each physician seeing the patient same day.

re: BILLING 99233

Typically each physician should use a different diagnosis code. For example, I'm a pediatrician so I use the pediatric codes as a consultant, the infectious disease, pulmonologist, nephrologist, etc, use different code. If 3 doctirs see the pt for "pneumonia", the sometimes the first bill gets paid and the others are denied.

re: BILLING 99233

I bill for an infectious disease specialist and it's not at all unusually for two doctors to use the same dx in one day. For example, it's not uncommon for the hospitalist to diagnose a patient with pneumonia or an abscess and decide it's severe enough to request that my doctor see the patient. She will diagnose the patient with the same condition and does get paid. On the rare occasion I get that denial, I will call and explain that she is a specialist. If they will not reprocess the claim over the phone, I'll mail in the dictation notes.

re: BILLING 99233

It's unfortunate, but the work falls on the office when the payer denies the second visit. the notes have to show medical necessity . The problem with hospital visits notes, sometimes, they are not legible, or are too brief to support the billing.