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need help CPT code and POS code - having a problem

  1. #1
    blue bell
    Default need help CPT code and POS code - having a problem
    Medical Coding Books
    my practice is having a problem....

    What code should i be using for a consult done in observation in the hospital but we r not the admitting doctor????

    Also what is the P.O.S. code for it????

    I have been using a new or est office level and the P.O.S. as 22.

    Is anyone else out there having the same problem???

    we r being denied for these claims from almost ever carrier.....

    i have also tried to use new or est office levels with P.O.S. as 23 still being denied..

    i am asking for any suggestion u may have, really need to get this resolved...

  2. Default
    It is appropriate to use a new or established office visit code with a place of service 22. There shouldn't be any reason for you to be getting denials. If you are getting denials, I would suggest you appeal.

  3. #3
    I would make sure the status of the patient wasn't changed to "in-patient" Also, some insurance companies still recognize consult codes. Be sure you are using these codes based on your payer. Otherwise, I would agree to use your new or est office codes. If using new office codes make sure the patient has not been seen with anyone in the practice/specialty within 3 years. The correct POS is 22.
    Linda Elley CPC, CPMA, CEMC

  4. Default
    I would use codes 99241-99245 as stated in the guidlines. I would use POS code 22.

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