Primary Care Coding Alert

Question: After seeing a female patient in his office, family physician (FP) A admits the patient to the hospital as an inpatient. He writes all the orders for admission, signs them and sends copies with the patient to the hospital. FP A, however, does not go to the hospital that day. On hospital rounds the next morning, FP B, who is in the same practice, sees the patient. How should I code for the admission, and which physician should report the service?

Tennessee Subscriber

Answer: The AMA book "Principles of CPT Coding" states that the initial hospital care code is for the "first inpatient encounter with the patient by the admitting physician. The date may not be the same as the date the patient was actually admitted to the hospital." Therefore, assuming both FPs are billing under the same provider number and thus are interchangeable as to the admitting physician, you should code the hospital service on the second day as initial hospital care (99221-99223, Initial hospital care, per day, for the evaluation and management of a patient ...) under FP B.