Wiki initial hospital care

[jscot76@wgu.edu]

There seems to be some confusion within our practice about how to code the first initial visit by our doctors when they are not the admitting doctor. According to the CPT book the description for 99221-3 these are to be used by the admitting physician. But some of our doctors are stating that they can bill those codes when they are not admitting physician as long as it doesn't have a modifier AI is not billed.

 

[thomas7331]

These codes are to be used by consulting (non-admitting) physicians for Medicare and other payers who do not accept the consultation codes (99251-99255). The AI modifier was created to distinguish between the admitting and consulting physicians in this situation.

 

[jscot76@wgu.edu]

Thank you for clearing that up.