Orthopedic Coding Alert

Reader Questions:

Clamp Down on Consult Miscoding

Question: If a managing physician asks the orthopedic surgeon for a consult on an inpatient with arm and wrist pain, what code should I report?

Oklahoma Subscriber

Answer: You should report an inpatient consult code (99251-99255) for this service.

Remember: The surgeon should document the request, examine the patient and share the results with the requesting physician for you to report a consult.

Tip: If the patient was admitted to "observation status," the consult would be an outpatient consult. If the patient was formally admitted as an inpatient, you should report an inpatient consult code.

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