Results 1 to 4 of 4

Consults

  1. #1
    Default Consults
    Medical Coding Books
    Now that medicare no longer pays consults you use 99221-99223 for inpatient consultations but do you still put a reffering doctor ? If you do not put one will it deny ?? I would say it's informational and wouldn't affect reimbursement or denials but would like additional feedback, I have been putting them and no problems yet. Thanks

  2. Default
    Quote Originally Posted by cpccoder2008 View Post
    Now that medicare no longer pays consults you use 99221-99223 for inpatient consultations but do you still put a reffering doctor ? If you do not put one will it deny ?? I would say it's informational and wouldn't affect reimbursement or denials but would like additional feedback, I have been putting them and no problems yet. Thanks
    from what i have seen, the consult code is for all physicians including the admitting physician. If you are billing for the admitting physician then a modifier goes on you consult code to state that you are the original physician, therefore i do not believe all the other physicians would need to indicate on their claim who the admitting/referring dr is.

  3. #3
    Location
    Columbia, MO
    Posts
    12,531
    Default
    99221-3 are not consult codes, they are initial inpatient visit levels. They are the levels you use for Medicare consults and all other carriers following Medicare policy on consults. The AI modifier is used on the initial inpaitient visit level if your physician is the admitting physician. The consulting physician uses no modifier. As far as putting the referring physician info on the claim, I say yes as CMS indicated in November of 09 that you should still capture the documentation and claim information the same as if you were billing consult codes as you may need that information in case an appeal is necessary.

    Debra A. Mitchell, MSPH, CPC-H

  4. #4
    Location
    North Carolina
    Posts
    3,126
    Default
    I agree with Debra.

Similar Threads

  1. Consults
    By 01085585 in forum E/M
    Replies: 3
    Last Post: 02-26-2016, 02:56 PM
  2. consults
    By pljames in forum Medical Coding General Discussion
    Replies: 4
    Last Post: 07-23-2009, 05:12 PM
  3. Help With Consults!!!
    By jfahan in forum E/M
    Replies: 3
    Last Post: 06-04-2009, 12:40 PM
  4. consults with same dx
    By coder1 in forum E/M
    Replies: 1
    Last Post: 05-30-2009, 05:29 PM

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?

Login

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.