Wiki 3 year rule I/P

[ejensen]

Does the 3 year rule apply to a patient who is returning to the hospital as a I/P and my provider previously say the patient?

 

[CodingKing]

The best way to know is to look at the codes for inpatient visits (99221-99239). Your answer will be right there.

 

[ejensen]

New scenario: We are billing for a I/P consult. The patient is an established patient because of prior care in the hospital with our provider. Would the patient still be considered new because it is a consult?
The reason I am asking is our billing software alerts us the patient has had face to face care within the last three years.

 

[CodingKing]

Same for consult codes if accepted by payer. code description will answer your question.