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Thread: Billing for initial hospital evaluation -Medicare

  1. #1
    Join Date
    Apr 2007

    Default Billing for initial hospital evaluation -Medicare

    AAPC: Back to School
    What does a specialist bill for initial hospital evaluation (usually consult) when they aren't admitting physician and patient has Medicare. There are 2 codes, Initial consultation (denied by Medicare), or Inpatient Visit Initial however this code specifically says: excludes visit by physician other than admitting provider.

  2. #2
    Join Date
    Apr 2007

    Default Initial Inpatient Care

    Medicare want you to use the initial hospital care codes 99221-99223 codes the first time your physician sees the patient in the hospital provided they meet the documentation requirements. If they do not meet these requirements, they are to use the subsequent hospital care codes 99231-99233. The admitting provider uses a modifier "AI" on their claim.

  3. #3
    Join Date
    Apr 2007


    Thank you, we will try that

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