Wiki E/M OBV Consult converted to Inpt Consult

[AmandaHartman]

Hi -
How would a hospitalist bill for the following scenario.

We are asked to consult on a patient that is in OBV status.
Day 1 initial consult we bill 99201-99205

On day 2, the attending of record, changes the patient to Inpt status.
Day 2 how do we bill
- Bill initial inpt consult 99221-99223 (as long as evaluation and documentaiton requirements are met for those codes)
Or
- Bill inpt follow up code 99231-99233

I can't seem to find this documented anywhere in the claims processing manual specifically. I did find the following
"If a patient is admitted to inpatient status from hospital observation care subsequent to the date of initiation of observation services, the physician must bill an initial hospital visit for the services provided on that date".
30.6.8 D

 

[jazzyblues2005]

First, is this a Medicare patient or no? If not Medicare you can use the outpatient consult codes (99241-99245). If it is, then you are correct with 99201-99205. On the subsequent day, if the status is changed, we bill a subsequent visit. So in this scenario I would bill a 99231-99233.