Admitting versus Attending Physicians
Differing Classifications Affect Clinical Documentation and Workflows
By Lou Ann Wiedemann, MS, RHIA, FAHIMA, CPEHR
UNDERSTANDING AN ORGANIZATION’S physician classifi- cations is important. Physician classifications drive documen- tation requirements such as history and physicals, consultation reports, and discharge summaries. In addition, physician clas- sifications often outline the extent of direct patient care a physi- cian has. Two important classifications are admitting and attending physicians. The Admitting Physician Admitting physicians are credentialed by the healthcare orga- nization to have admitting privileges. Admitting privileges are
granted by the governing board to a clinical care provider to
provide direct patient care within the hospital. Admitting privileges are different from clinical privileges, which are defined by
the care provider’s license, experience, and competencies.
An admitting physician is the clinical provider responsible for
admitting the patient to the hospital. The admitting physician is
responsible for certain documentation such as accurately iden-
tifying the:
Only one clinical provider can be designated as the admit-
ting physician and bill for an inpatient encounter using the CP T
initial hospital care codes (99221–99223). If two or more physi-
cians are involved in the care of a patient, one must be identi-
fied as the admitting physician, and the remaining physicians
considered consultants.
Physicians may be granted emergency admitting and clinical privileges. These emergency privileges are granted by the
governing board, chief of staff, or the hospital’s chief executive
officer. These appointments are made in emergency situations
and can be made without regard to the care provider’s regular
service assignment or status.
Take for example a hospital that has a neurosurgeon on staff
who dies of a sudden illness. The chief of staff could extend
emergency admitting privileges to a second neurosurgeon to
provide coverage until a replacement is located.
Physicians may also be granted temporary admitting and
clinical privileges. These temporary privileges are granted by
the organizational designee such as the chief of staff or chief executive officer. Temporary privileges are granted for a specified
time period.
For example, physicians on an organ donation procurement
team may not be members of the regular medical staff but may
be given temporary admitting and clinical privileges to perform
organ-harvesting activities.
The Attending Physician
An attending physician, also called a staff physician, is a clinical provider who has completed a residency program and practices within a clinic or hospital. Attending physicians usually
supervise other clinical providers such as fellows, residents, and
medical students within an academic medical center. They have
the final legal responsibility for the quality of patient care and
documentation provided during the inpatient visit.
In some instances attending physicians may still be receiving
training, as is the case with fellows. For example, a cardiology
fellow may continue to function as an internal medicine at-
