Ask the expert: Can a consult by a hospitalist at admission suffice as an H&P that must be done pre-operatively?
Hospitalist Leadership Connection, April 25, 2007
Q: In some cases, PCPs affiliated with our facility who use hospitalists only for night coverage want to do their own history and physicals (H&Ps) when they come in to the hospital. In other cases, where the hospitalist takes over the entire care of the patient during hospitalization, the hospitalist can bill an H&P. What is the right way to look at this?
A: If the hospitalist performs a comprehensive evaluation, the consult note can be used to satisfy The Joint Commission requirement for preoperative history and physical. It can still be billed as a consultation, but note that if the hospitalist provides ongoing management for one or more problems, Medicare will pay only a subsequent care code, even for the initial evaluation.
Richard E. Rohr, MD, FACP, director of hospitalists at Milford (CT) Hospital, fielded this question. Rohr can be reached at Richard.Rohr@milfordhospital.org.
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