Wiki Billing Consultation then Follow-Up

[chrissylyman0629@gmail.com]

Billed non-medicare patient 99253 inpatient consultation on 1/5/2017. Patient was discharged on 1/7/2017. On 1/12/2017 the patient was seen in the office for a follow-up to discuss test results. How would the 1/12 visit be coded? An Established E/M (99213?). Or should it be billed as an office consultation? (99243?)

 

[mhstrauss]

Billed non-medicare patient 99253 inpatient consultation on 1/5/2017. Patient was discharged on 1/7/2017. On 1/12/2017 the patient was seen in the office for a follow-up to discuss test results. How would the 1/12 visit be coded? An Established E/M (99213?). Or should it be billed as an office consultation? (99243?)

I would expect this to be an established E/M. Technically, it COULD be a consult, since consult codes don't have the same 3-year requirements as other office visit codes, but it's highly unlikely to meet the consult requirements again so soon. And since you're stating that the visit is for "follow-up to discuss test results", it sounds like a regular established visit.

HTH!