Results 1 to 4 of 4

Inpatient consult.

  1. #1
    Default Inpatient consult.
    Medical Coding Books
    If the referring physician isn't documented for an initial inpatient consultation-
    Can you code it as an initial inpatient visit instead?
    99255 vs 99223

  2. #2
    Sarasota FL
    Quote Originally Posted by smalldetails View Post
    If the referring physician isn't documented for an initial inpatient consultation-
    Can you code it as an initial inpatient visit instead?
    99255 vs 99223

    No you can't. If it is a commercial insurance that still accepts consult codes, you must bill an IP consult code, with a referring provider documented. No matter how bad the documentation, you will be able to code it to 99251-99255. You can only bill an initial visit(I presume you mean an H&P) if your provider is the admitting.
    You cannot bill an H&P just to give your provider more money, or just so you don't have to communicate with the provider to add the referring to the documentation.
    I would class that as fraud(intent to obtain pecuniary advantage knowing that it is wrong).
    Do you look good in orange?

  3. Default
    My opinion :- The "RRR" will need to match for consultation code. If the insurance was commercial bill with 99251-99255. If it is a Medicare, need to bill with initial inpatient visit ( 99221-99223) as per guideline.

  4. #4

    You missed the question all together.
    Referring physician info is missing altogether.
    No need for you to be so rude.

Similar Threads

  1. ER Consult vs Inpatient Consult
    By lcouto in forum Emergency Department
    Replies: 1
    Last Post: 10-22-2015, 10:08 AM
  2. inpatient consult
    By trose45116 in forum E/M
    Replies: 1
    Last Post: 10-19-2015, 10:41 AM
  3. Inpatient Consult PLEASE HELP!!
    By smshortcake in forum Medical Coding General Discussion
    Replies: 1
    Last Post: 11-08-2013, 02:35 PM
  4. Inpatient consult
    By khopstein in forum E/M
    Replies: 1
    Last Post: 04-30-2013, 01:42 PM
  5. Inpatient Consult
    By lmsnyfla in forum E/M
    Replies: 5
    Last Post: 04-08-2009, 07:10 AM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?


Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.