Ask the Expert: Hospitalist Coding & Billing
Question: I am searching for any documentation that supports compliant billing for a hospitalist group and what hospitals can and should do.
Many providers are now employing hospitalists for their inpatient stays. Since patients may be admitted, treated, and discharged by many physicians during that stay, who is truly considered the "attending physician" for compliant billing purposes? Must it be the physician that "admitted" the patients (even though that physician may not see the patients again during their stay)? Is it the "discharge" physician who wrote the orders, after care, and/or any combination of those? Can it be a "supervising" physician of the actual group? Any thoughts would be greatly appreciated.
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Answer: Here are two references I have used in the past on the evaluation and management coding of hospitalist services:
- Revisions to Consultation Services Payment Policy, MLN Matters, MM6740 Revised: Nov. 8, 2011
- Section 30.6.8, Medicare Claims Processing Manual, Chapter 12, Physicians/Nonphysician Practitioners (Note: All of section 30.6.8 (A through E) is relevant to hospitalist billing, especially part D.)
This answer was supplied by Bill Gutekunst, FHFMA, coordinator reimbursement & compliance, Southeastern Regional Medical Center, Lumberton, N.C., and a member of HFMA's North Carolina Chapter (firstname.lastname@example.org).
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Publication Date: Monday, November 19, 2012