Test your knowledge about...

Specialist Hospital Visits

This short self-quiz will test your understanding of MSP billing policies and procedures for specialist hospital visits.

Question 1

A General Surgeon performed an appendectomy (fee item V72656) on a patient. What fee should the surgeon bill for a follow-up visit in the hospital the next day?

  (a) Fee item 71008 (post operative visit, in-hospital - 1 to14 days post-operatively)
  (b) Fee item 07008 (subsequent hospital visit)
  (c) Fee item 07007 (subsequent office visit)

Question 2

What is the payment formula for directive care?

  (a) 2 visits per week
  (b) 3 visits per week
  (c) 2 visits per calendar week (Sunday to Saturday)

Question 3

A Vascular Surgeon performed a thrombectomy (fee item 77115) on a patient on December 01, what should the surgeon bill from December 02 to 15 for the 14 hospital visits following surgery?

  (a) 77006 (directive care)
  (b) 77008 (subsequent hospital visit)
  (c) Visit fees are not payable as the surgical fee includes 14 days post-operative follow-up visits in hospital. For extenuating circumstances, an explanation must be provided with the claim submission and independent consideration will be given

Question 4

A patient is admitted to the hospital with multiple medical conditions. A Cardiologist is providing daily care for the patient’s heart condition, and an Endocrinologist is also managing the patient’s severe diabetes condition daily. How should the hospital visits be billed during the first 30 days?

  (a) The Cardiologist may bill daily under fee item 33008 (subsequent hospital visit) The Endocrinologist may bill directive care under fee item 33206 (directive care) on a daily basis
  (b) The Cardiologist may bill directive care up to twice per calendar week under fee item 33006 (directive care). The Endocrinologist may bill daily care under fee item 33208 (subsequent hospital visit)
  (c) The Cardiologist may bill daily care under fee item 33008 (subsequent hospital visit), the Endocrinologist may also bill daily care under fee item 33208 (subsequent hospital visit)

Question 5

A prostatectomy (fee item 08311) was performed on a patient by a Urologist on December 01. The care of this patient was transferred to another Urologist in the same community. How should the second Urologist bill the hospital visits from December 02 to December 20?

  (a) As daily care, 19 x fee item 08008 (subsequent hospital visit)
  (b) 5 x fee item 08008 (subsequent hospital visit), the surgical procedure billed by the first Urologist includes 14 days post-operative in-hospital care, The 14 hospital visits billed from December 02 to 15 would be refused with explanatory codes QE and FF, 5 x fee item 08008 (subsequent hospital visit) would be paid from December 16 to 20 if the medical condition necessitates these visits

QE (Service is within the pre or post-operative period.)
FF (Payment for the full fee has been paid to another physician; we do not split the fees.)

  (c) As directive care, 8 x fee item 08008

Question 6

A patient was admitted to the hospital on December 15 for a pancreatectomy (fee item V71712), the patient was hospitalized until January 20 and care was provided by the operating surgeon. How should the General Surgeon bill for this hospital stay?

  (a) 37 x fee item 07008 (subsequent hospital visit)
  (b) 12 x fee item 07006 (directive care)
  (c) FROM December 16 TO 29............14 x fee item 71008 (post operative visit, in hospital 1-14 days post-operatively)
FROM December 30 TO 31........02 x fee item 07008 (subsequent hospital visit)
FROM January 01 TO 20.........15 x fee item 07008
As the surgery is “V” prefixed, fee item 71008 would be billed for the 14 days following surgery, daily care would be billed under fee item 07008 from December 30 to January 13 and then 2 per week (7 days) for long-stay from January 14 to 20