We are a group of 5 neurologists and 2 nurse practitioners. We have hospital privileges at the local hospital where we provide consultation services. The hospital just recently hired a neuro-hospitalist. She is an employee of the hospital, not a locum tenen. We will now be sharing call on a one week on/one week off rotation with the hospitalist.

My doctors question how they may bill THEIR first encounter with a patient when they provide hospital services for the first time. Their point of view is that the patient would be new to our practice, justifying a 99222 when billing Medicare. However, my concern is that 99222 requires a comprehensive history, comprehensive exam, and moderate decision making. I am concerned that Medicare would question medical necessity of a comprehensive history, etc. when the patient has been "worked up" initially by another neurologist.

I'd appreciate any thoughts regarding this, and would be most grateful if someone could point me to documentation that covers this scenario.

Thanks for your help.