AAPC - Back to school
Results 1 to 5 of 5

Thread: Using Mid-Levels for Hospitalist Program

  1. #1
    Join Date
    Apr 2007
    Dover Seacoast New Hampshire

    Default Using Mid-Levels for Hospitalist Program

    AAPC: Back to School
    Hi, I oversee the coding department for a facility that employs a hospitalist group. They would like to begin using mid-levels to perform Initial Hospital Services (in this case, admissions).

    The issue is that they want to also bill for same-day Hospitalist (MD) services prior to the admission; the MD hospitalist has made the decision to admit, but brings the mid-level in to do the H&P. After I explained that we cannot bill two Hospitalist services for the same day, and went over the other scenarios we can/can't do (shared visits, concurrent care, etc.), the hospitalist director insists that this is being done nationwide. It may very well be, but I'm not sure who is able to get away with billing both services.

    Anyone out there who is billing a hospitalist MD visit and a hospitalist mid-level visit on the same day (related to the admission?) Thanks! Pam
    Pam Brooks, MHA, CPC, PCS, COC
    Coding Manager
    Wentworth-Douglass Hospital
    Dover, NH 03820

    If you can dream it, you can do it. Walt Disney

  2. #2


    we only bill for the hopsitalist admission. They ins is only going to pay for 1 from the same group.
    adrianne, cpc

  3. #3


    We do have a similar scenario. Midlevels often see the patient and complete the H and P as preparation. The physician then comes in and repeats an exam and finalizes MDM. We bill this service under the physician, even though the midlevel is involved. The physician should be doing most of the documentation (his exam and mdm).

    What service is the MD trying to bill prior to admission? Office visits? We have physicians who bill office visits and send patients over for admission, but the office visits are not paid.

  4. #4
    Join Date
    Apr 2007
    Dallas, TX


    I do the coding for a large hospitalist dept in Texas and we also use mid-level to admit and for subsuquent visits. The mid-level does the H&P and then the doctor comes in and does the exam and plan, tieing in with the mid-levels H&P. So both notes are used for the E&M code. The mid-level sometimes does the intire admission and bills under their number. So either way will work.

    I hope this helps,

    "Life isn't about waiting for the storm to pass...It's about learning to dance in the rain."

  5. #5
    Join Date
    Apr 2007
    Kachina Coders


    I too code for a group of hospitialist. Whenever the mid-level does a admit or subsequent visit the Physician must also sign the documented note. There are guidelines as to what must be documented by the Physician. This is a split visit and both get RVU's for it. If the Physician does not sign off the note he does not get RVU .
    Mesa, AZ

Similar Threads

  1. Mid Levels
    By jcox in forum Orthopaedics
    Replies: 1
    Last Post: 10-29-2015, 01:03 PM
  2. Ancillary & Mid-Levels
    By pvacanti in forum Urology
    Replies: 1
    Last Post: 08-26-2015, 08:16 AM
  3. 99307 and mid-levels
    By coachlang3 in forum Medical Coding General Discussion
    Replies: 0
    Last Post: 11-13-2014, 09:07 AM
  4. mid levels and time - incident to
    By trinapitsch in forum E/M
    Replies: 2
    Last Post: 06-21-2013, 04:41 PM
  5. Critical Care and Mid Levels?
    By Annette in forum Medical Coding General Discussion
    Replies: 0
    Last Post: 05-14-2007, 03:31 PM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts

Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?


Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.