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Thread: Billing for Hospitalists

  1. #1
    Join Date
    Apr 2007
    Oakbrook, IL

    Default Billing for Hospitalists

    AAPC: Back to School
    I have a two-part question.
    When billing for hospitalists, if a patient is in the icu and they don't actually round on the patient until they are transferred to the floor, will this effect reimbursement in any way? So let's say for example, that the patient is in the icu for 4 days and being followed by a pulmonologist and then is trans to the floor at the end of the 4th day and the Hospitalist doesn't see him until the start of the 5th day, would this cause a red flag to Medicare?
    Secondly, lets say the same patient on the 7th day of care is transferred to Hospice care, would the hospitalist bill for subsequent visits on the 8th, 9th, etc day or for a discharge and admit on those dates? Thanks, I would appreciate any advice.

  2. #2


    If the patient in not in ICU and the doctor did not visit him in the ICU do not bill for it. If the patient goes into hospice care
    and your doctor is non-hospice bill with the GW modifer for non-hospice provider. I would bill for all the
    dates you doctor sees the patient based on what his services are 99231, 99232, 99233,99238

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