G. Initial Hospital Care Visits by Two Different M.D.s or D.O.s When They Are Involved in Same Admission
In the inpatient hospital setting all physicians (and qualified nonphysician practitioners where permitted) who perform an initial evaluation may bill the initial hospital care codes (99221 – 99223) or nursing facility care codes (99304 – 99306). Contractors consider only one M.D. or D.O. to be the principal physician of record (sometimes referred to as the admitting physician.) The principal physician of record is identified in Medicare as the physician who oversees the patient’s care from other physicians who may be furnishing specialty care. Only the principal physician of record shall append modifier “-AI”, Principal Physician of Record, in addition to the E/M code. Follow-up visits in the facility setting shall be billed as subsequent hospital care visits and subsequent nursing facility care visits.
I do not agree that every initial, inpatient visit should be coded as 99223. You report the appropriate initial code that supports the documentation. As for the admitting MD, he reports the initial visit with AI modifier to indicate that he/she is the admitting MD. This is how Medicare differentiates between the admitting and another MD rendering service.
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