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Wiki Hosp consult on your own pt

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Kim M Gordon

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When you are called in for an inpatient consult (urology) by another physican for a patient that you see in your office, is this charged as a consult ( 99221-99225 for medicare or 99251-99255 commercial) or an e/m level (99212-99214) ? This has been a big discussion for us, i have always been shown code "where the pt is (by site) so I think it is the inpt charges even though the pt is an estblished pt in the office. Thanks in advance :)
 
Patient is inpatient status so these would default to inpatient codes. Our standard of practice is if Medicare we convert to 99221-99223 based on documentation. If they do not meet those requirements then it would go to the subsequent follow up visits such as 99231-99233. You should not be using est patient codes for a patient that is inpatient. We are still billing consults to those companies that accept them. Hope this helps.

Kelsey, CPC
 
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