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Hospitalist Billing

  1. #1
    Location
    Seacoast- Dover New Hampshire
    Posts
    609
    Default Hospitalist Billing
    Exam Training Packages
    Is there a modifier that needs to be used for them? Thanks
    Karen Barron, CPC
    Hampton New Hampshire Chapter

  2. #2
    Default
    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)
    Last edited by ARCPC9491; 03-13-2009 at 08:11 AM.

  3. #3
    Location
    Seacoast- Dover New Hampshire
    Posts
    609
    Default
    Do they stand alone or bill under some one else.
    Karen Barron, CPC
    Hampton New Hampshire Chapter

  4. #4
    Default
    Their independent from the hospital - physician owned. Is that what you mean?

  5. #5
    Location
    Seacoast- Dover New Hampshire
    Posts
    609
    Default
    He is to be employed by the hospital.
    Karen Barron, CPC
    Hampton New Hampshire Chapter

  6. #6
    Default 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...
    Cindy

  7. #7
    Location
    Milwaukee WI
    Posts
    4,466
    Default 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

  8. #8
    Location
    Seacoast- Dover New Hampshire
    Posts
    609
    Default
    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.
    Karen Barron, CPC
    Hampton New Hampshire Chapter

  9. #9
    Location
    Burlington MA
    Posts
    13
    Default
    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.

  10. #10
    Default
    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.

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