Hospitalist Billing

ARCPC9491

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I'm trying to rack my brain.... modifiers are rarely used with hospitalists because they are strictly inpatient. Very rarely will they perform a procedure (always minor) it's normally just E/M. (For my hospitalists at least) The only thing that comes to mind off hand is when say they do a subsequent care and a critical care, you'd use modifier 25 on the sub care.

oh let me add - occasionally we'll get a denial for a hospice patient and sometimes we'll have to throw on the GW modifier (service not related to hospice patient's terminal condition) or GV modifier (attending physician not employed or paid under arrangement by the patient's hospice provider)
 
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cisaac

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hospitalist

Does anyone bill for hospitalist who are separate from the hospital? I have a question about same day admit/discharge and my hospitalist disagrees with me on the criteria and wanted me to find out how other hospitalist groups are reporting when the pt is admitted one day((usually late night before midnight) but the attending doesn't see the pt until the next morning and that is also the discharge day...
 
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Milwaukee WI
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Admit/Discharge same day

If patient is admitted late in the evening on day 1.
But physician doesn't actually see patient until day 2, and later discharges patient on that same date.

Then ...
Code 99234-99236 depending on documentation.

The key is when the physician provided the service, not when the hospital admitted the patient.

F Tessa Bartels, CPC, CEMC
 

kbarron

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Ossipee, NH
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I have 4 hospitalists that are employed by the hospital. Who would be the billing physician? Do they bill with their own NPI? Also one of the "Hospitalists" is a physician in a Hospital owned practice, can he bill under himself and see pt on the SNF?Hopefully not everyone has gone the the conference.
 

JennH

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Burlington MA
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I'm having the same problem, but my issue is 2 different hospitalists. Dr. "A" admits the patient at 1am, Dr. "B" discharges the patient at noon, WHO gets the credit for the same day admit/discharge? Our doc's contracts are based on their number of charges submitted.
 

ARCPC9491

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You have to set up an internal policy as to how you will handle admissions and discharges by different physicians. I know it may be difficult to avoid doing so, but only one physician can get credit.
 

JennH

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Burlington MA
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Management is working on it, I've been told. I hope it's resolved soon, it is causing a lot of problems. I appreciate your reply.
 

dentfam

Networker
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Santa Rosa
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I do Hospitalist Billing too

Just an FYI--I have been billing for a group of Hospitalists for a little over a year now. Our physicians are independent from the hospital and are salaried, so I bill the physician that provides the majority of the service for the calendar date usually.
 

Gemini18

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NYMAC, GMAC
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Hospitalist

Hi -

I audit for hospitalist as well and they use modifiers here. Why is this incorrect? I thought they would be coded as regular physicians.
 
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