Urology Coding Alert

Question: If my urologist sees a patient in office for say BPH, then he is admitted for something else, and the admitting physician consults my urologist for BPH, is it a new consult?Alabama Subscriber Answer: In this case the coding would depend on the payer’s consultation rules. If following Medicare rules, in-hospital consultations are billed with the initial hospital visit code 99221-99223 (Initial hospital care, per day, for the evaluation and management of a patient …) whether the patient is old or new. The same holds true if the payer follows CPT® rules. In-hospital consultations would be billed with the older CPT® codes 99251-99255 (Inpatient consultation for a new or established patient …) whether the patient is a new or old patient. All this assumes that consultation requirements are met. If there is no consultation requested, and the admitting physician only wishes the urologist to also follow the patient in the urologist’s case for the [...]