Medicare consult for domiciliary, rest home, assisted living visits

SUEV

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If a doctor is asked by an appropriate source to do a consult on a patient in the above settings, what codes should we use to bill Medicare? Do we just use the 99324-99337 codes or do we use the 99201-99215 codes? Outpt Consult codes 99241-99245 can be used for these settings but will Medicare process 99201-99215 with POS 13 or 33? I have not been able to find guidance from CMS specifically for these locations and since the rules regarding Inpt (use Inpt codes) vs. Obs (use Outpt codes NOT Obs codes) vs. ER (use ER codes) consult code choices are different, I'm hoping someone knows.
Thank you for any advice you can give,
Sue
 
Thanks for the link Cindy. I had seen it but didn't understand why they would say "report the most appropriate available code to bill Medicare for services that were previously billed using the CPT consultation codes" but then require Outpatient codes for Observation patients instead of the Observation admission and subsequent visit codes. I was wondering if other sites had similar exceptions. Since I can't find any, I'll use this article as my reference.
I appreciate your response :)
Sue
 
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