Consult-Office to NF

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3
Location
Avon, OH
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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

Networker
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Location
Chehalis, WA
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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

True Blue
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Baton Rouge
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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!
 
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