I have a physician (A), not the admitting, who is covering for another physician (B). He has seen a number of this physicians (B) patients in the hospital and is coding them as subsequent. I believe he should be coding these as initial inpatient consults and subsequent thereafter. This I based on the guidelines noted under “Initial Hospital Care”:
“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.”
He also states that if he sees a patient in the office, as a covering provider, it is a new patient to him, hence he would code as new patient. In this situation, he should be coding it as an established patient since he is covering for patients primary doctor. Again, this is based on CPT guidelines for New and Established patients.
I would greatly appreciate insight and assistance in clarifying this issue so that going forward, the doctor and I are on the same page.
“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.”
He also states that if he sees a patient in the office, as a covering provider, it is a new patient to him, hence he would code as new patient. In this situation, he should be coding it as an established patient since he is covering for patients primary doctor. Again, this is based on CPT guidelines for New and Established patients.
I would greatly appreciate insight and assistance in clarifying this issue so that going forward, the doctor and I are on the same page.
