• 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 Outpatient follow-up (New or Established codes)

chestede

Contributor
Messages
10
Location
Mesa, AZ
Best answers
0
If a patient is seen in the hospital for a consultation requested by another physician (this consulting provider has never seen this patient before), would you use one of the "Initial Inpatient Consultations" codes? Then, if that consulting provider follows up with that patient on an outpatient basis like a week later, would that patient have a "New" or "Established" patient E & M code? (that consulting provider only saw him once before, in the hospital.)
 
If a patient is seen in the hospital for a consultation requested by another physician (this consulting provider has never seen this patient before), would you use one of the "Initial Inpatient Consultations" codes? Then, if that consulting provider follows up with that patient on an outpatient basis like a week later, would that patient have a "New" or "Established" patient E & M code? (that consulting provider only saw him once before, in the hospital.)

For NON-Medicare patients, you would select 99241-99245 for outpatient consultations. For NON-Medicare patients, you would select 99251-99255 for inpatient consultations. If the patient follows up with this physician or a member of his group specialty (in the office) the patient would be considered established to the practice.

If this is Medicare: Medicare no longer recognizes consultations and the new guidelines would apply.
 
Top