• If this is your first visit, be sure to check out the FAQ & read the forum rules. To view all forums, post or create a new thread, you must be an AAPC Member. If you are a member and have already registered for member area and forum access, you can log in by clicking here. If you've forgotten the password it can be reset on our sign in section by entering your registered Email Address or Username here. To start viewing messages, select the forum that you want to visit from the selection below..

Wiki Need Help W CONSULT code(s)

Create Wiki
A

aikido22

New
Messages
5
Location
Jacksonville, FL
Best answers
0
If you do not have the formal consult request (99251-99255), do you down code to 99221 -99223, etc or do you downcode to the subsequent visit 99231 -99233 etc?

Also, this is for non medicare insurance**
I know for Medicare patient's we only use code 99221-99223.
 
Yes

Well, the answer to your question depends on several factors.

If the patient is covered by Medicare (or a carrier who is following CMS guidelines re consults), then you code based on whether this is the FIRST inpatient visit or a subsequent inpatient visit.

If the patient is covered by a carrier who accepts the consultation codes, then you have to code as subsequent (because those carriers only accept ONE initial hospital visit code, from the admitting physician).

Hope that helps.

F Tessa Bartels, CPC, CEMC
 
You must log in or register to reply here.
Top