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Thread: Coding For Hospitalist Group

  1. #1

    Default Coding For Hospitalist Group

    AAPC: Back to School
    I was wondering if anyone does coding for hospitalist groups? I'm going to start soon and was curious to see if anything is different or if there are different rules? Or if there is a site where I can do some research?

    Thanks in advance.

  2. #2


    I have a 22 hospitalist client.

    Send me your questions!! I will help

  3. #3
    Join Date
    Apr 2007
    Santa Rosa


    I code for a Hospitalist group as well.

  4. #4

    Default code 96116

    In a hospital outpatient if you have 99242 and 96116 do you need a modifier?
    Can you help me with that?



  5. #5


    96116 "mini mental exam" is included under the psych bullets (1997 guidelines) when a physician performs a mini mental he/she would get the bullets for the items they documented. so sometimes when other things are being examined, the psych bullets can help get a higher level exam.

  6. #6

    Default For codes 99213 and 96116

    Can I send it both in the same day of service or only, 96116?

  7. #7

    Default What you mean by bullets, can you be more specific

    Can you be more specific with the meaning bullets. Can I send 99242 and also 96116

  8. #8


    pull up the psychiatric "bullets" under the "general multi system exam" in the 1997 documentation guidelines.

    If your provider has an expanded problem focused exam (needed for 99242) the extra bullets for the psychiatric exam (which is a mini mental or 96116) may allow your physician to get a higher level exam, such as detailed (which is needed for 99243) it might bring up the overall E/M visit, as long as the history and medical decision making meet as well.

  9. #9


    I code for a hospitalist group also. My biggest frustration is helping the docs to understand the difference between a consultation and a transfer of care. The Medicare Carrier's Manual is really helpful with this issue.

    Annette, CPC

  10. #10
    Join Date
    Apr 2007
    Bay City


    I too code for a hospitalist group which also include Midlevels. Does anyone else have Midlevels? This part is new to our practice, and we have had some push back from the Midlevels, as to what they can and can't bill for in the hospital setting under the split/shared visit.
    ~Kimberly Maher, CPC

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