Pop the champagne cork & get ready for brand new inpatient coding rules.
With the changes to consult coding in 2010, it will be more important than ever to report hospital visits properly.
In the past, only the admitting physician reported initial hospital care codes (99221- 99223), and specialists who saw the patient separately often billed inpatient consult codes. With the no-pay policy on consult codes, CMS is poised to allow specialists to bill initial hospital care for their first visit with a patient.
Modifier addition: Because multiple physicians may end up billing the initial hospital care codes during a patient’s visit, CMS will release a new modifier in 2010 that will signify which physician admits a patient to the hospital, says Melissa Briggs, CPC, with Stormont-Vail HealthCare in Topeka, Kan.
In black and white: “Because of an existing CPT coding rule and current Medicare payment policy regarding the admitting physician, we will create a modifier to identify the admitting physician of record for hospital inpatient and nursing facility admissions,” the CMS Physician Fee Schedule Final Rule indicates.
“For operational purposes, this modifier will distinguish the admitting physician of record who oversees the patient’s care from other physicians who may be furnishing specialty care.”
Each physician will be able to bill from the 99221-99223 code range only once, after which they’ll report subsequent hospital care codes (99231-99233).
Keep an eye on the Part B Insider, where we’ll update you on the information about the new modifier as soon as CMS releases it.
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