medicare outpatient consultation

[mmcneil]

One of my Physicians saw a Medicare patient for a consultation prior to a procedure, which was then performed and patient was discharged the same day. Patient was admitted through ER. What code would I use for the consultation?

 

[dclark7]

Since Medicare does not pay for consults you would use the appropriate E/M code (99221-99223 for initial inpatient or 99201-99205/99212-99215 for office or outpatient). If a procedeure was done then you would have to add teh appropriate modifier 57 or 25 depending on the global days assigned to the procedure.

 

[Naveen Rachagolla]

This link will help you regarding consultants for medicare patients.

http://emuniversity.com/Consultalgo.pdf