I have recently been tasked with billing consults (call coverage) for a medical orthopedic practice, it's been a while, and I want to make sure I understand the current guidelines.
Here are my "burning questions":
If the patient is seen by Ortho MD in the ED and then admitted to Observation status for dx of fracture care do I bill CPT code ED (99281-99285) or do I bill Initial Hospital Inpt or Observation care (99221-99223)? I think I should be billing the Initial Hospital Inpt or Observation- because, based on dx Ortho will most likely be the lead MD on the case, and POS should be OP, because the patient was admitted to Observation. or should it be Emergency Department because that is where consult took place?
If an Ortho MD sees in ED for an ortho-related dx, and the patient is admitted by a hospitalist for medical conditions. I would bill the ED codes, with the POS of the Emergency Dept? -even if the patient is admitted as an inpatient?
What if a general Ortho MD sees the patient in the Emergency Department, the patient is admitted to the hospital and then the general Ortho MD that saw the patient in Emergency Department, requests a consult from the Hand Specialist (same practice) to see the patient on a subsequent day. Can I bill for both Ortho consults? Is one initial and the other subsequent (99231-99233) or are both initial?
It is all a bit of a quandary for me. I greatly appreciate the support and/or suggestions for reference materials.
Here are my "burning questions":
If the patient is seen by Ortho MD in the ED and then admitted to Observation status for dx of fracture care do I bill CPT code ED (99281-99285) or do I bill Initial Hospital Inpt or Observation care (99221-99223)? I think I should be billing the Initial Hospital Inpt or Observation- because, based on dx Ortho will most likely be the lead MD on the case, and POS should be OP, because the patient was admitted to Observation. or should it be Emergency Department because that is where consult took place?
If an Ortho MD sees in ED for an ortho-related dx, and the patient is admitted by a hospitalist for medical conditions. I would bill the ED codes, with the POS of the Emergency Dept? -even if the patient is admitted as an inpatient?
What if a general Ortho MD sees the patient in the Emergency Department, the patient is admitted to the hospital and then the general Ortho MD that saw the patient in Emergency Department, requests a consult from the Hand Specialist (same practice) to see the patient on a subsequent day. Can I bill for both Ortho consults? Is one initial and the other subsequent (99231-99233) or are both initial?
It is all a bit of a quandary for me. I greatly appreciate the support and/or suggestions for reference materials.