According to CMS policy 100-4, 12, 30.6.8 only the phys ordering the observation svc can bill the observ codes of 99220-99226 - all other physicians that consult or see the pt during this time must bill regualar outpt codes - can anyone tell me what place of service they should use for these consults - 22?
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Wiki Physician Consultations during Outpt Observ
- Thread starter lbach
- Start date
KSNAVELY
New
Use the 22 place of service to bill the consultation. however if you are billing a insurance
company that does not accept consult codes you must bill outpatient E/M services for new or established patient. ie 99201-99205 or 99211-99215
company that does not accept consult codes you must bill outpatient E/M services for new or established patient. ie 99201-99205 or 99211-99215
hewitt
Expert
Do not forget to append the AI modifier to E&Ms for those carriers not honoring consult service CPTs! Per Medicare:
"Can you confirm when I'd use the AI modifier?
The AI modifier (Principal Physician of Record) is appended by the principal physician of record to the evaluation and management (E/M) code. Medicare defines the principal physician of record as the physician who oversees the patient's admission and care."
"Can you confirm when I'd use the AI modifier?
The AI modifier (Principal Physician of Record) is appended by the principal physician of record to the evaluation and management (E/M) code. Medicare defines the principal physician of record as the physician who oversees the patient's admission and care."