Wiki Inpatient Hosptial Follow Up with PCP --HELP!!!

YLEWI2

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Hello my coding friends,
Will some please help me? What is the CPT code do I assign when someone was released from the hospital (inpatient) and the go the PCP for follow up? Is is just a regular established E&M code?

Thanks for your support!!!
 
Yes, you would use the office visit codes if that is where the patient is being seen and if they have seen the physician within 3 years it is established.
Pay attention to why the patient was in the hospital. If this si a follow up to a procedure that may have been day you will have a 0 charge (99024) due to potential global days.
 
Yes, you would use the office visit codes if that is where the patient is being seen and if they have seen the physician within 3 years it is established.
Pay attention to why the patient was in the hospital. If this si a follow up to a procedure that may have been day you will have a 0 charge (99024) due to potential global days.

Correct, you would use the office E/M codes for this visit. However, only if the PCP was the one who performed the procedure would it be considered part of the global period. That is usually the case for a surgeon, not a PCP. :)
 
Coding hospital f/u

I would first check the insurance then use the TCM codes. for discharge up to 7 days use 99496 and if it is 8-14 days then use 99495.Medication reconciliation should be coded along with that too. Know your payers because some do not acknowledge this CPT code and will push it to the patient responsibility.

**hope this helps
 
While TCM codes would be an option you must make sure the parameters have been met for the usage of the codes. There are services that are a required component of these codes such as contact within 2 business days of discharge. Along with Medical decision making of at a minimum moderate as well as timing of the visit. These can be a great solution, if you plan ahead for them.
 
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