A physician may report only a single inpatient consult per inpatient stay. CPT® instructions state, “Only one consultation should be reported by a consultant per admission. Subsequent services during the same admission are reported using Subsequent Hospital Care codes 99231-99233 or Subsequent Nursing Facility Care codes 99307-99310,” depending on the setting.
For example, a hospital inpatient experiences a new onset of atrial fibrillation. The managing physician requests a consultation from a cardiologist for her advice on the patient’s care and management. The cardiologist examines the patient, schedules a cardiac catheterization and other diagnostic tests, and sends a written report to the requesting physician. Following the advice and intervention by the cardiologist, the managing physician resumes the patient’s general medical care. In this case, the cardiologist may report an inpatient consultation for her services at the level supported by documentation. If the cardiologist follows up with the patient during the same inpatient stay; however, she must report the visit(s) as subsequent inpatient care (99231-99233), as appropriate to the documented service level.If the same physician provides a legitimate consult service during a different inpatient stay for the same patient (whether for the same or a different problem), the physician may report another inpatient consult code, as appropriate to the documented service level.
For instance, the patient in the previous example has been discharged, only to be re-admitted several weeks later. If the same cardiologist who reported the previous consultation meets the requirements for a consultation service during the subsequent stay, she once again may report an inpatient consultation code (99251-99255) for her services.