Wiki Hospital Billing

[tnicholson]

I have a scenerio that needs clarification please! If our physicians have an existing patient that is admitted to the hospital (and they are not the admitting physician) can they use the Initial Hospital visit code (inpatient) with a modifier the first time they see the patient even though the admitting physician would have already used this code? We currently use the subsequent visit codes for existing patients seen in the hospital when we are not the admitting physician. One of our docs received advice at a coding seminar to use the initial hospital visit code with a modifier. I hope that makes sense! I appreciate any feedback available.

 

[mitchellde]

If you are consulted for a condition that you do not follow the patient for then you would use the initial codes with no modifier. If you follow the patient for a problem(s) and are called to inform you that the patient is now in patient and you go to see your patient then you use the subsequent visits.
The AI modifier is for the admitting provider to use when they do the admission and bill an initial level.