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E/M or admit??

Janet Posted Mon 31st of October, 2011 21:08:31 PM

Pt seen in office by PA for rectal bleeding, he was admitted a few hours later by PCP for rectal bleeding and my dr did hosp consult on same day. Can I bill both? If not which one should be billed out?

SuperCoder Answered Wed 02nd of November, 2011 13:40:33 PM

For your doctor who did a consult on the same date of admission, you can bill a code from 99221-99224, based on documentation. This is to be done in addition to billing a code from 99221-99224 with IA modifier, for the admitting PCP. Modifier IA shows the service provided by admitting doc.

SuperCoder Answered Wed 02nd of November, 2011 13:42:20 PM

So there could be the same code (99221-99224) reported twice on the same day, once for the consult doctor and once for admitting PCP. But the differentiating factor is appending modifier AI, which would accompany the code billed for admitting doc.

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