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Inpatient consult/follow-up office visit

  1. #1
    Default Inpatient consult/follow-up office visit
    Medical Coding Books
    Could someone please tell me the correct way to code an inpatient consult with follow-up in the office. Before the consult the patient was not seen by this physician. Would it still be the 99211-99215 codes because the physician saw pt?

  2. #2
    Default
    Yes, this is now an established patient. Face to face service was provided which is the definition of an established patient per CPT.

    Laura, CPC

  3. Default
    I agree with Laura

  4. #4
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    North Carolina
    Posts
    3,126
    Default
    Ditto......

    In the office or other outpatient setting, following the initial consultation service, the Office or Other Outpatient Established Patient codes (99212 – 99215) shall be reported for additional follow-up visits. The CPT code 99211 shall not be reported as a consultation service. The CPT code 99211 is not included by Medicare for a consultation service since this service typically does not require the presence of a physician or qualified NPP and would not meet the consultation service criteria.

    http://www.cms.hhs.gov/manuals/downloads/clm104c12.pdf

    30.6.10

  5. Default
    Quote Originally Posted by spitfire View Post
    could someone please tell me the correct way to code an inpatient consult with follow-up in the office. Before the consult the patient was not seen by this physician. Would it still be the 99211-99215 codes because the physician saw pt?
    yes with modifier 11 (location other than hospital)
    love to code- cs

  6. #6
    Default
    Quote Originally Posted by RebeccaWoodward* View Post
    Ditto......

    In the office or other outpatient setting, following the initial consultation service, the Office or Other Outpatient Established Patient codes (99212 – 99215) shall be reported for additional follow-up visits. The CPT code 99211 shall not be reported as a consultation service. The CPT code 99211 is not included by Medicare for a consultation service since this service typically does not require the presence of a physician or qualified NPP and would not meet the consultation service criteria.

    http://www.cms.hhs.gov/manuals/downloads/clm104c12.pdf

    30.6.10
    Just as a side note...

    My post is from 2009. Consultations are no longer applicable to Medicare.
    Rebecca Cross CPC, CPMA, CEMC


    http://thebreastcancersite.greatergo...oGive/bcs/home !!!*************!!!
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