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Wiki Inpatient surgical consult -Medicare Please help

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cwestman

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I have zero experience with inpatient CPT coding ,but was approached by billing dept requesting help to bill a surgical consult for an inpatient .
I was advised Medicare will not cover consult visit so not able to use 99251-99255 I would think EM OV 99202-99205 or 99212-99215 wouldn't be appropriate either The consult did lead to a decisions for surgical intervention so would this be global under the procedure ? If surgery wasn't the same day?
If surgical intervention wasn't warranted would it be appropriate to use and EM for an OV?
Appreciate any help,and TIA
Cheri CPC-A
 
I was advised Medicare will not cover consult visit so not able to use 99251-99255 I would think EM OV 99202-99205 or 99212-99215 wouldn't be appropriate either

You would choose from the initial inpatient visit codes 99221-99223 if it is the first encounter with the patient during this admission. If you have seen the patient previously during this admission you would choose from 99231-99233


The consult did lead to a decisions for surgical intervention so would this be global under the procedure ? If surgery wasn't the same day?

The decision for surgery for major procedures (90 day global) is not included in the Global Surgical Package and should be billed with -57 modifier
 
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