• If this is your first visit, be sure to check out the FAQ & read the forum rules. To view all forums, post or create a new thread, you must be an AAPC Member. If you are a member and have already registered for member area and forum access, you can log in by clicking here. If you've forgotten the password it can be reset on our sign in section by entering your registered Email Address or Username here. To start viewing messages, select the forum that you want to visit from the selection below..

Wiki Consult coding question

Messages
128
Best answers
0
My physician is called to the hospital ER department to perform a consult on a patient. Another physician outside my group admits the patient and my doctor decides to perform a minor procedure the same day as the consult. I've read you're suppose to use the 25 modifier on the E&M when a minor procedure with 000 global days is done. I'm not sure this is correct as they are kicking out in our claims edits.

Also, even though my physician sees the patient in the ER do I still bill the encounter as a consult or an ER visit?

Thanks for your time.
 
Typically, if the pt is admitted, then the consult would reflect the admit level (inpatient, or OBS.) We frequently have this happen in our office, and we always bill the consult with a -25 and the minor procedure, and don't have any trouble. Hope this helps!
 
Top