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Admitting physician for non-medicare patients

  1. #1
    Default Admitting physician for non-medicare patients
    Medical Coding Books
    If one of our general surgeons did a consult in the ER and decided to admit the patient, would I use a code from 99241-99245. The patient was NOT medicare. Also if our doctor is the admiting patient, do I need to have some special modifier for a non-medicare patient?

    Thanks for your help!

  2. Default
    Are you talking about inpatient admit or OBSV admit?

    Are you sure he was called for a consult in the ER? If he is consulting, then it is not his patient and he can not admit. He can only advise the treating physician as part of his consult opinion that he advises an admit.

    Was he really called to the ER to eval and treat the patient? If so, then he can direct admit the patient

    Did he consult but then assume care after the consult?

    If he admits the patient direct from the ER, then you can code only the intiial inpatient E&M codes, 99221-99223. His E&M service he provided in the ER rolls into the inpatient admit E&M.

    You would combine and code the admit with 99221-99223. The admitting mod -AI that identifies the admitting physician is only for medicare patients

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