Wiki Consult-Office to NF

[SuperSAS20**]

Our docs are requested to perform consults for pain management. If they perform an initial consult/visit in the office (99204) and then see the patient in a nursing home a week later, is this initial (99305) or subsequent (99308)? What if they see them later in the hospital? Would this be initial (99221) or subsequent (99232)?

 

[jonique.dietzen]

If all visits are billed under the same practice, both of the follow up visits in the nursing home and/or hospital would be considered subsequent/established patient visits.

Jonique Dietzen, CPC

 

[mhstrauss]

If all visits are billed under the same practice, both of the follow up visits in the nursing home and/or hospital would be considered subsequent/established patient visits.

Jonique Dietzen, CPC

I respectfully disagree. The Inpatient POS and NF POS sections of the E/M codes don't follow new/establ rules. If you look at the section heading for these codes, you'll see they are for new OR established patients. The "initial" codes 99221-3 and 99304-6 are just that...the initial visit that the provider is performing for that inpatient encounter.

HTH!