new to GI coding

CPCA2016

Networker
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I have recently started coding for GI and I have several questions to you seasoned coders out there...your input is appreciated!
Is anyone billing for the consult appointment before the colonoscopy? I understand this is generally not a covered visit but I also understand many physicians are billing for them. I am referring to new patient, never had a colonoscopy before, some with symptoms, some with out.
I was told recently that Medicare and Medicaid are no longer covering a consult in or out patient when patient is in hospital or observation prior to an EGD or other GI procedures but I was told to bill them using the office visit codes-is anyone doing this? I'm not sure I am comfortable doing that and that is why I am asking.
Thank you for your input!
 

cgaston

Expert
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Clarence, NY
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Medicare hasn't paid for consultation codes since 2010.

So the correct codes choices for new patient consultations are the 99201-99205 for outpatient/observation services and 99221-99223 for inpatient services.
 
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Medicare hasn't paid for consultation codes since 2010.

So the correct codes choices for new patient consultations are the 99201-99205 for outpatient/observation services and 99221-99223 for inpatient services.


You know I was just looking in here and my coder did ask me the same question and when I told her that medicare stopped using these codes. Her answer was I'm not sure about that.. LOL!! She also mentioned I'm not comfortable with that.. Everyone knows how this has changed.. You know if I just got into the field I would have questioned myself or if my husband wasn't a physician and has been using these codes sine 2010 I would have said to her you know your right let me double check.. UGGHHH this is frustrating when your coder questions everything.
 
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