decisionhealth Newsletters, Coder Pink Sheets - 2006 Issue 12 (December)
Bill for floor time when meeting with family in hospital - even if you are not the attending
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Article Overview
This article covers hospital E/M billing when a physician is involved in inpatient care but is not the attending physician, especially when time is spent communicating with family members on the hospital floor. It highlights the general distinction between routine social visits and billable services, the use of time-based hospital visit reporting, and the way CPT and Medicare each treat floor time and family discussions. The piece is aimed at family physicians, internists, coders, and others who bill inpatient services and need to understand the scope of documentation and reporting considerations.
Why This Topic Matters
Correctly identifying when inpatient floor time is reportable can affect claim accuracy and reimbursement. The article is relevant for clinicians and coders who manage shared inpatient care, consultative situations, and family communication during hospitalization.
Article Sections
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Bill for floor time when meeting with family in hospital
Introduces the overall topic of inpatient billing when a physician is not the attending and spends time with family members on the hospital floor. It distinguishes general presence from services tied to patient care.
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Supplemental codes and time-based hospital visits
Discusses the broad categories of inpatient E/M reporting referenced in the article and how supplemental involvement is framed. It also addresses the role of time-based reporting in the hospital setting.
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CPT and Medicare differences
Summarizes that the article compares guidance from CPT with Medicare rules for inpatient floor time and family discussions. It notes that the two sources are not treated identically.
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Floor time and family discussions
Covers the general concept of floor time and how time spent communicating with family may factor into service selection. It also notes that the discussion remains focused on the patient’s care needs.
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Other possibilities
Mentions an alternate inpatient reporting category when the physician is asked for opinion or advice. This section situates that possibility within the broader inpatient billing discussion.
What You Will Learn
- How inpatient physician involvement may be viewed when the doctor is not the attending
- How time spent on the hospital floor and with family can relate to E/M reporting
- How CPT and Medicare guidance differ in the inpatient setting
- What kinds of documentation considerations are emphasized for family discussions
- When an inpatient consultative scenario may be relevant
Who Should Read This
- Family physicians
- Internists
- Medical coders
- Billing staff
- Hospital-based clinicians
Codes Discussed
Code Ranges Discussed
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