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ICU charge and subsequent hospital charge on same day?

Eva Posted Tue 20th of March, 2012 17:39:43 PM

My provider saw a pt in the ICU and charged for it. Later the same day, the pt was transferred to the general Med floor and the provider saw the pt again and charged for a subsequent visit.
Can we bill for both? I know that we can only bill one Visit per day.
Am I missing something?

SuperCoder Answered Tue 20th of March, 2012 17:45:22 PM

The general rule of thumb is that there can only be one E/M code per day. Per the CPT manual, "The most common practice is to report a single visit code per day, evaluating all services provided during that day to arrive at the correct level of service. Prolonged service codes may be used to report services beyond the usual."

So, combine the two services together, which may result in a higher level new pt visit or if the two services together were extensive, you may be able to use the prolonged service code(s). Hopes this helps.

Eva Posted Tue 20th of March, 2012 17:48:50 PM

That is what I thought. Thank you.

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