Wiki H&P Consults done in the hospital for outpatient surgery

[cmcmahon]

Anyone have experience with this? If I'm looking at CPT correctly it looks like the Medicare codes are different from the commercial payor codes 99201-99205 vs 99241-99245. Is this correct?

 

[clarkmegan]

Yes, Medicare requires you to bill 99221-99223 instead of consults. If your dr is the admitting physician then you add modifier -AI.

 

[cmcmahon]

Outpatient H&P

Aren't 99221 - 99223 for inpatient?

 

[clarkmegan]

Yes, they are. For outpatient cases you would bill a new or established office visit unless your doctor admitted them to Observation status. In that case you would bill observation codes, but only if he is the ordering physician.