Hospital coding and billing mistakes can cost your hospitals thousands of dollars. Here are a couple of hospital billing & coding scenarios to help your understanding and save you from unnecessary denials.
Scenarios: After treating a patient in the office, our physician admitted her to the hospital later the same day. How should we go about this situation? Can we bill for the office visit and the first day of admission? Or do we just bill for the hospital stay?
Well, it all depends on whether your physician tends to the patient on the same day in the hospital.
Two face-to-face visits on the same date
If the physician tends to the patient in the hospital on the same day he saw her in the office, you are looking at two face-to-face visits on the same date. Go for only the proper initial hospital care code - (99221-99223, Initial hospital care, per day, for the evaluation and management of a patient ).
CPT coding guidelines ( Source "http://www.supercoder.com/cpt-codes/") lay down that all initial hospital care services that start in another place of location (say for instance the physician's office) should be combined and coded using the proper level of initial hospital care. As the 99221-99223 code will include the evaluation & management provided in the office, you will go for an initial hospital care code that includes the work done in both sites of the service.
Bill each encounter separately
However if your physician doesn't see the patient in the hospital until the next day, you should bill each encounter separately. Select the proper office visit code (99201-99205 or 99212-99215) for the visit on day one. After this add an initial hospital care code 99221-99223 for day two when the physician tends to the patient in the hospital for the first time.
Bear in mind: CPT uses initial hospital care codes to code the first hospital inpatient encounter by the admitting physician. Soon after that, you will report subsequent hospital care codes - 99231-99233 - until the date of discharge. After the physician discharges the patient, you will submit the proper hospital discharge day code (99238 or 99239, Hospital discharge day management ).
Scenarios: After treating a patient in the office, our physician admitted her to the hospital later the same day. How should we go about this situation? Can we bill for the office visit and the first day of admission? Or do we just bill for the hospital stay?
Well, it all depends on whether your physician tends to the patient on the same day in the hospital.
Two face-to-face visits on the same date
If the physician tends to the patient in the hospital on the same day he saw her in the office, you are looking at two face-to-face visits on the same date. Go for only the proper initial hospital care code - (99221-99223, Initial hospital care, per day, for the evaluation and management of a patient ).
CPT coding guidelines ( Source "http://www.supercoder.com/cpt-codes/") lay down that all initial hospital care services that start in another place of location (say for instance the physician's office) should be combined and coded using the proper level of initial hospital care. As the 99221-99223 code will include the evaluation & management provided in the office, you will go for an initial hospital care code that includes the work done in both sites of the service.
Bill each encounter separately
However if your physician doesn't see the patient in the hospital until the next day, you should bill each encounter separately. Select the proper office visit code (99201-99205 or 99212-99215) for the visit on day one. After this add an initial hospital care code 99221-99223 for day two when the physician tends to the patient in the hospital for the first time.
Bear in mind: CPT uses initial hospital care codes to code the first hospital inpatient encounter by the admitting physician. Soon after that, you will report subsequent hospital care codes - 99231-99233 - until the date of discharge. After the physician discharges the patient, you will submit the proper hospital discharge day code (99238 or 99239, Hospital discharge day management ).
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Certified medical biller and coders in NH are paid higher than their non-certified colleagues too. As mentioned earlier, a non-certified worker with 6 years of rendered service make $36,000 a year. A certified worker with the same work experience is paid $42,000. That’s a difference of about $6,000 in a year. Those who have 15 years of work experience but are not certified billers and coders earn $45,000 annually while a certified employee gets $50,000. Medical Billing and Coding Salary in New Hampshire
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