Hospice exam
I'm new to this, but looking in CPT, page 31 E/M , is one mention of Hospice care, but not specifically the exam- the code is 99377, for Care Plan Oversight Services by the Physician. Also V66.7 is the code for palliative treatment-i.e. in Hospice care.
From reading E/M section, page 23, it says that all the E/M services, including the exam, provided by the admitting physician on the same day the patient was admitted to the Nursing Facility, can be included in the Initial Nursing Facility Care-(but not specifically mentioning Hospice-just Nursing Facility). If your physician IS the admitting physician, he can't bill for Initial Nursing Facility care since he didn't see the patient until 48 hours after admission, as you said. This can be the physician who last saw and examined the patient on the date of admission, and prescribed the Nursing Facility for them (again is Hospice included?)
Can your physician encounter after 48 hours be billed as Subsequent Nursing Facility Care if he was not the first examining MD on date of admission ? It sounds like he could be allowed to bill for Subsequent Nursing Facility Care if the Hospice IS included in Nursing Facilities. Since Hospice is mentioned in code 99377, I'm not sure if it is considered a Nursing Facility to be used in the codes on page 31.
I don't find Hospice mentioned elsewhere right now.
I hope I've helped you .