Hospital Visits

raidaste

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I code for a Critical Access Hospital owned Ortho clinic. The provider was req'd to consult on a Medicare inpatient patient. I have read the Manual and am now quite confused on what I should be coding for this consult. I know that Medicare doesn't accept consult codes, but am not sure if I should be coding initial inpt, subsequent inpt or regular new/established e/m codes for my providers service:confused. Any help would be nice.
Thanks:confused:
 

jmcpolin

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Salt Lake City
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Initial consult if Medicare you could code 99221-99223, in our state the only Ins still acception consult codes is United Healthcare. The admitting Dr. would code 99221-99223AI .
 

raidaste

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That is what I thought but for some reason the more I read, the more confused I became.
Thanks
 

solocoder

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Springfield, Mo
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I'm confused too

I thought I had this straight too, but the CPT manual says that "initial" codes are "used to report the first hospital inpatient encounter with the patient by the admitting physician".
OK, so what about the intial inpatient visit by the consulting physician? Does that have to be a "subsequent" code?
 

jmcpolin

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If the the consulting dr is just doing a consult and not assuming care he can bill the 99221-223 codes or subsequent whichever documentation supports, The admitting Dr. would bill 99221-223 with the AI modifier to differentiate between the 2.
 
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