My set up is different and I don't have rad/onc but I can tell you what we do in similar situations.
We bill what we do. If my doctors goes in the hospital and does a consult we bill an inpatient consult pos 21. If the patient comes to the office we bill an outpatient consult with pos 11. Doesn't matter if the patient is technically inpatient, we are using our staff and our resources and the service was provided in our outpatient office.
I have one practice this happens in fairly regularly and the only time we have ever had a rejection was for the inpatient side. We saw the patient as an inpatient and billed as such but the insurance reviewed the case and took it down to an obs status so we had to change our coding after the fact in that case.
Just my experience for what its worth,
Laura, CPC, CEMC
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