decisionhealth Newsletters, Coder Pink Sheets - 2009 Issue 8 (August)
Be prepared to use new ‘admitting physician’ modifier
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Article Overview
This article covers a CMS fee schedule proposal affecting hospital inpatient and nursing facility admission billing. It is aimed at coders, billers, and compliance staff who follow Medicare Part B policy and CPT evaluation and management guidance. The discussion focuses on the planned modifier, the physician of record concept, and how admission and subsequent care reporting are being addressed in the proposal.
Why This Topic Matters
The proposal could change how admitting physicians are identified on initial inpatient and nursing facility claims, so practices need to watch for final-rule guidance and implementation timing.
What You Will Learn
- How CMS is proposing to identify the admitting physician of record
- How the proposal relates to hospital and nursing facility admission billing
- What types of inpatient and subsequent care reporting are being discussed
- When the modifier was expected to be released and implemented
Who Should Read This
- Medical coders
- Billing staff
- Compliance professionals
- Physician practices
- Hospital revenue cycle teams
Codes Discussed
Code Ranges Discussed
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