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CMS Will Offer New Modifier to Denote Admitting Physician on Claims

Posted on 22. Nov, 2009 by in Provider News

Pop the champagne cork & get ready for brand new inpatient coding rules.

With the changes to consult coding in 2010, it will be more important than ever to report hospital visits properly.

In the past, only the admitting physician reported initial hospital care codes (99221- 99223), and specialists who saw the patient separately often billed inpatient consult codes. With the no-pay policy on consult codes, CMS is poised to allow specialists to bill initial hospital care for their first visit with a patient.

Modifier addition: Because multiple physicians may end up billing the initial hospital care codes during a patient’s visit, CMS will release a new modifier in 2010 that will signify which physician admits a patient to the hospital, says Melissa Briggs, CPC, with Stormont-Vail HealthCare in Topeka, Kan.

In black and white: “Because of an existing CPT coding rule and current Medicare payment policy regarding the admitting...

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