Wiki Hospital Consult

[01102849]

This is my first post so here goes:

Our physician gets called in for a hospital consult for stones. Pt was admitted for abdominal pain. Previous ESWL done about 2 wks prior. Patient is not in the room when he arrives. He reviews the chart, labs and ct scan. Patient has abdominal pain and determines its not related to the stone but due to appendicitis. NO physical exam done by our physician since pt was not in the room and MDM show no intervention at this time. Would we still use 99221 or is there some other code that would be better. What would be the appropriate code to use?

Thank you for any help.

 

[mitchellde]

If e provider did not see the patient face to face, then there can be no visit billed.

 

[emcee101]

agree with Debra. without a fece-to-face visit, you cannot bill for this E/M service. Your doc should have waited for the patient to return.

 

[01102849]

Thanks

 

[philipwells]

We billed for a group of hospitalist that must have been billing it wrong.They were always under the impression if the physician reviewed the charts and ordered labs or tests then face to face time wasn't necessary, considering some patient's will either be asleep or sedated.

Thanks in advance!

 

[michelleaapc2012]

If the patient is asleep the provider can still review everything and document that the patient was sleeping or sedated at the time.

 

[CodingKing]

If the patient is asleep the provider can still review everything and document that the patient was sleeping or sedated at the time.

Exactly, patient doesn't need to be conscious to do an exam. They physician should have waited until the patient returned and complete the remaining portion of the face to face visit.