Forum - Questions & Answers
99235
Is this code payable for two days in a row for a Medicare patient?
If the documentation backs it up
Pt in ED, placed OPO in hospital, doc sees pt, sends home->99235. Next day pt back in ED, again put in hospital OPO, doc sees pt, sends home again->99235. Just be sure the second document is complete and does not just say "see prev H&P for details." The MAC will compare these codes the the hospital bill and see that they make sense.
99235
Is the patient in Observation two days in a row? In that case, this is not the correct code to use.
Use 99235 when the patient is admitted and discharged (inpatient or OBS status) in the same calendar date, and for Medicare, is in OBS for more than 8 hours. The physician must see the patient twice, for the admission and for the discharge. There must be two notes.
Can you expand on your situation?