# Inpatient E/M Hospitalist question



## joannrl (Dec 22, 2008)

We have a specific E/M situation at our hospital and would truly appreciate
some expert advise with respect to E/M coding.  We have just assumed the
billing responsibility for the Hospitalist program.

Psych MD admits patient  (psych dx).  Psych MD is part of the Psych
group at the hospital.   Hospital requires History and 
Physical but this is outside the scope of practice for the Psych MD.
The H&P is performed by a Hospitalist on the same day as the admission.

How would the Psych MD and the Hospitalist each code their services? 
A reference to any published guidelines would be most helpful - we have
been unable to locate anything to fit this specific situation 

Thanks!


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## LLovett (Dec 22, 2008)

I have never personally dealt with this type of situation but in reading the CPT guidelines for Initial Hospital Care it appears to cover this.

"For initial inpatient encounters by physicians other than the admitting physician, see initial inpatient consultation codes (99251-99255) or subsequent hospital care codes (99231-99233) as appropriate."

Since this is a requirement by the hospital and not a true request for opinion, I would think that the hospitialist would have to use the subsequent care codes.

On a side note, is the psychiatrist doing a detailed exam? 

Hope this helps,

Laura, CPC


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## joannrl (Dec 23, 2008)

Hi Laura,

Yes, that does help.  We have learned that the Psych MD is actually seeking medical mgmt from the Hospitalist, not requesting opinion or advise.

Your feedback is very appreciated!


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