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Wiki Billing A Consult In An Observation

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kfrycpc

kfrycpc

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IBC is denying consult code 99254 and place of service 21 for a consult service that was during a patient's observation stay. The provider actually saw her in the emergency dept. What code should be used?
 
kelliep said:
IBC is denying consult code 99254 and place of service 21 for a consult service that was during a patient's observation stay. The provider actually saw her in the emergency dept. What code should be used?
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POS for ED is 23, and the ED consult codes are 99281-99285.
 
Observation is an outpatient service, meaning your E&M code is incorrect right off. Too, Observation is a status, not a physical location.

99241-99245 are consultations that occur in the outpatient area (including the ER).
 
kevbshields said:
Observation is an outpatient service, meaning your E&M code is incorrect right off. Too, Observation is a status, not a physical location.

99241-99245 are consultations that occur in the outpatient area (including the ER).
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Thank you Kevin. Incidentially, this payer was Medicare who does not accept consult codes. So what should we use instead?
 
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