Cardiology Coding Alert

Question: How should I code a consult that my physician performed when a patient was admitted for an observation stay?

Wisconsin Subscriber

Answer: Fight the temptation to report observation codes 99218-99220 (Initial observation care, per day ...). Payers consider a consult while the patient is in observation to be "outpatient," so you should report 99241-99245 (Office consultation for a new or established patient ...).
 
Only one physician should report an observation admit code per observation stay.
 
Note: If your cardiologist admitted the patient to the hospital following the consultation, you should only report the hospital admission service because CPT defines these codes (99221-99223) as "per day" codes.  Specifically, these codes include all E/M services provided to the patient on the day of admission, from all different places of service (such as office, ED, observation, etc.).