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Thread: Medicare Inpatient Consult Codes

  1. #1
    Join Date
    Apr 2007

    Default Medicare Inpatient Consult Codes

    AAPC: Back to School
    For Medicare patients:

    My docs do not always meet documentation guidelines for 99221, it was my understanding of the new inpatient consult rules, that Medicare wants you to use inpatient follow up codes 99232;99233 if documentation is not met for 99221? When I do this I get denied stating services are included in global, even though I use mod 24. Is anyone else having this issue? It looks to me like they are assuming it is included because I used follow up code. Needless to say, no it is not included, it is completely different body part, hence the 24.

    How do I resolve this issue?

    Should I send them their own guidelines(ha)?

  2. #2
    Join Date
    Apr 2007
    North Carolina


    Sometimes I do; even with a different dx and mod. 24. Resubmit the claim with an appeal letter/reconsideration and documenation to prove your case.

    Good luck~

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