heatherwinters
Expert
If you read my previous post, last week National Government Services indicated that all clinicians could report an initial care code for their first encounter with a patient, as long as no one else from your practice treated the patient during that admission.
I gave them the scenario, if a patient is admitted over the weekend and I assume care on Monday as their primary, would I bill initial or subsequent care (different practice admitted), last week they said, bill an Initial Care Code with the AI modifier---- Today that has changed.
Now they are saying:If a patient is admitted over the weekend by another doctor from a different practice and you see the patient for the first time on Monday, you will still bill the subsequent care code and not the initial care code, even though it is your first encounter with that patient and nobody else has seen them from your practice. I think they are looking at where you "asked" to see the patient by another doctor for your opinion, so they are still applying the consultation rules, just not paying you for the consultation codes. Has anyone else gotten the same clarification on this?
I gave them the scenario, if a patient is admitted over the weekend and I assume care on Monday as their primary, would I bill initial or subsequent care (different practice admitted), last week they said, bill an Initial Care Code with the AI modifier---- Today that has changed.
Now they are saying:If a patient is admitted over the weekend by another doctor from a different practice and you see the patient for the first time on Monday, you will still bill the subsequent care code and not the initial care code, even though it is your first encounter with that patient and nobody else has seen them from your practice. I think they are looking at where you "asked" to see the patient by another doctor for your opinion, so they are still applying the consultation rules, just not paying you for the consultation codes. Has anyone else gotten the same clarification on this?