punkyboo
Networker
I think I know the answer to this question but I need something in print. So far I have been unable to find documentation on this subject, so I need some enlightenment.
One of our physicians did an inpatient hospital consult, but it was really an initial hospital visit since the patient has Medicare. Anyway, this patient was new to him, but his documentation did not meet the required criteria and therefore (as far as I know), the visit would have to be billed as a 99499 with the documentation to be sent out as requested.
Someone in our office suggested that I bill the visit as a hospital follow-up visit (subsequent hospital care). It's my understanding that we cannot do this, since the patient had never been seen by this doctor or any other doctors in our group, previously. In fact, another doctor in our group saw the patient the following day in the hospital.
I know a lot of things changed when Medicare stopped recognizing consultation codes, but as far as I know, the rules to bill follow-up (subsequent) hospital visits had not changed.
So, is my only option to bill the visit with a 99499? I cannot crosswalk it to any other "new patient hospital" codes, from his documentation.
Also, if anyone could point me in the direction of any websites, or anyplace that could further define/explain the rules of this kind of billing, I would really appreciate it.
Thanks in advance!
One of our physicians did an inpatient hospital consult, but it was really an initial hospital visit since the patient has Medicare. Anyway, this patient was new to him, but his documentation did not meet the required criteria and therefore (as far as I know), the visit would have to be billed as a 99499 with the documentation to be sent out as requested.
Someone in our office suggested that I bill the visit as a hospital follow-up visit (subsequent hospital care). It's my understanding that we cannot do this, since the patient had never been seen by this doctor or any other doctors in our group, previously. In fact, another doctor in our group saw the patient the following day in the hospital.
I know a lot of things changed when Medicare stopped recognizing consultation codes, but as far as I know, the rules to bill follow-up (subsequent) hospital visits had not changed.
So, is my only option to bill the visit with a 99499? I cannot crosswalk it to any other "new patient hospital" codes, from his documentation.
Also, if anyone could point me in the direction of any websites, or anyplace that could further define/explain the rules of this kind of billing, I would really appreciate it.
Thanks in advance!
Last edited: