1. jarndtx1

    Wiki Observation and Inpatient billing

    Hello, I need a bit more of understanding on this. When an insurance does not accept a consult and they are billed in an observation setting, I know they are to be billed as an office exam. My question is if they are seen the next day and still being seen as in observation do we still bill...
  2. L


    Hello, My company would like to start billing for our short phone conversations and emails. 99441-99443, 99421-99423. Here is our situation. We provide free phone consults to patients. However, when they come for surgery, we do a full H&P and bill a new patient code with surgery. My...
  3. jkyles

    Wiki 2023 E/M guidelines

    The guidelines that will go into effect 1/1/2023 are available. Enjoy! :geek:
  4. J

    Wiki Changes to Consult Codes 99241-99245 In 2021?

    So they are changing the way outpatient E/M coding is in 2021, deleting the 99201 and only requiring the codes to be reported based on time or MDM, however I have not seen any mention of things changing for the consult codes. Seems odd considering the codes follow the same general principals. On...
  5. M

    Wiki Coding CONSULT when pt is a Preop clearance???

    Hi y'all, I am getting mixed answers to a question. If an ESTABLISHED patient comes into their family Dr and has to have a PREOP CLEARANCE is it ok to bill a consult code (99242--99245)??? I was always taught this was not allowed, that they can bill an higher established level. They insist I am...
  6. D

    Wiki My physician asked to consult in ER

    I'm a chart auditor for a large urology group and there is some dispute on our providers providing a consult in the ER. Patient is Medicare and we are NOT admitting the patient to our service. I was told that we should be using 99201-99205 or 99212-99215 as the patient is "out patient" and we...
  7. S

    Wiki ADD/ADHD Consults

    I had a meeting with my providers and a question came up about when they have add/adhd evaluations. They wanted to know if they are allowed to charge a 99213 even though they did not exam the patient. I told them let me get some advice and I will let you know. I thought about it last night and I...
  8. A

    Wiki Consult before Colonoscopy

    Can I get feedback on how you are billing your consults before a colonoscopy? Thank you very much for your time!
  9. N

    Wiki ER vs Inpatient E&M code

    Hi everyone! Any help would be appreciated!!! Neurosurgeon is on call. He sees the patient in the ER, but, the patient is admitted the same day. Do I code as an inpatient or do I code the ER consult? I was told that only the ER physician can code ER consults. And, per Medicare of VA, you can no...
  10. A

    Wiki Does referring to a specialist or a "Consult" counts for "additional work up" ?

    Does referring to a specialist or a "Consult" counts for "additional work up" ? Does referring to a specialist or a "Consult" counts for "additional work up" when leveling e/m visits? and also what are some examples of "drug therapy requiring intensive monitoring from physician in the "risk"...
  11. E

    Wiki Consult with POS ER for Medicare

    I have been coding ER visit codes 99281-5 for the crosswalk for Medicare Consults when the POS is the ER and not crosswalking to OP visit codes new or established for Hospitalist and Orthopaedic consults ;I use those when the POS is Obsrv. Can anyone tell me if I am correct to bill the ER codes...
  12. S

    Wiki Intraoperative consults

    What E/M code do you use when billing for an intraoperative consult?
  13. M

    Wiki FP performing Consults?

    I have been stirring about this and I just cannot think of any examples where a Family practice doc would be billing a consult? I have a doc (who always has to "beat the system" in some way, shape or form) who all of the sudden wants to bill consults. I would think he would be the one sending...