inpatient consults

[Tina Thompson]

i have a physician who sees consults inpatient only we are a psychiatric specialty. since cms will no longer take consult codes if we are not the admitting physician but consulting i know we will bill a regular admit with no modifier but what do we do for a follow up visit?

thanks
tthompson@altapointe.org

 

[rachelefporter]

if you mean f/u in the hosp then I believe the encounter is bundled into the subsequent inpt e/m via the attending...hope this helps

i have a physician who sees consults inpatient only we are a psychiatric specialty. since cms will no longer take consult codes if we are not the admitting physician but consulting i know we will bill a regular admit with no modifier but what do we do for a follow up visit?

thanks
tthompson@altapointe.org

 

[deyoung]

For us, the subsequent visit codes aren't changing; it's just the initial visit that changes because of the consult codes, for CMS, being eliminated. Depending on the service, you can use the inpatient subsequent codes 99231 to 99233, psychotherapy codes, or Rx management codes.

 

[MnTwins29]

Treat that like any other subsequent visit

Code the subsequent visits as you would any other f/u visits - the subsequent inpt E/M would be used, as it always has been. Just like when the consultation codes were used, there is no difference in subsequent visits between the admitting MD and consultants.

 

[martyzal]

Inpatient

In a Psy. hospital and you have 1 physician see patient initially, then he requests one of his partners do a second opinion due to a Bakers Act. What code can you use for the second opinion since you can no longer use a consult code with Medicare?

 

[jgarcia619]

Please help

I have a psych MD that bills consults for hospice pts. If a patient was seen by a Pain MD in our practice and bills now a 99223, can a psych MD bill a new pt code if he is part of the same practice? Is he considered a specialist?

Also do MD/Psych MD's have to follow the consult documentation guidelines when billing the new codes in place of the consult codes?


Please help?

Thank you
Jen

 

[FTessaBartels]

Different specialty

I have a psych MD that bills consults for hospice pts. If a patient was seen by a Pain MD in our practice and bills now a 99223, can a psych MD bill a new pt code if he is part of the same practice? Is he considered a specialist?

Also do MD/Psych MD's have to follow the consult documentation guidelines when billing the new codes in place of the consult codes?


Please help?

Thank you
Jen

If the physicians are of different specialties they bill independently of one another, even if in the same practice.

At this time only MEDICARE (and Medicaid in some states) has dropped the consultation codes. If your patient is covered by medicare you will bill the appropriate level E/M based on whether you are seeing the patient in the office, the ER, as an inpatient, in the nursing home, etc. You need to follow the CPT guidelines as to place of service, new vs established, etc for choosing the correct CPT and level of service.

If the patient is NOT covered by Medicare (or Medicaid if your state Medicaid is following T-19) then code it the way you always have.

There is a ton of information about these new guidelines on these forums. Search for "No more consultation codes" to find them.

F Tessa Bartels, CPC, CEMC