I wrote about the elimination of consultation codes in this week's issue and wanted to correct a point I made toward the end of the article.
The new modifier mentioned in the article -- which wasn't fully detailed in the final 2010 Medicare Physician Fee Schedule -- will distinguish the admitting physician. The admitting physician, who's coordinating the patient's care, appends the modifier to the initial care code billed for the service. After Jan. 1, specialists seeing inpatients will bill an initial care code instead of an inpatient consult code.
After an initial visit, physicians providing subsequent care bill the appropriate subsequent care codes.
Here's what it says in the final rule (pg. 178):
Because of an existing CPT coding rule and current Medicare payment policy regarding the admitting physician, we will create a modifier to identify the admitting physician of record for hospital inpatient and nursing facility admissions. For operational purposes, this modifier will distinguish the admitting physician of record who oversees the patient's care from other physicians who may be furnishing specialty care. The admitting physician of record will be required to append the specific modifier to the initial hospital care or initial nursing facility care code which will identify him or her as the admitting physician of record who is overseeing the patient's care. Subsequent care visits by all physicians and qualified NPPs will be reported as subsequent hospital care codes and subsequent nursing facility care codes.