AAPC - Back to school
Results 1 to 4 of 4

Thread: Observation consult then office visit next day

  1. #1

    Default Observation consult then office visit next day

    AAPC: Back to School
    I need your opinion please

    Medicare Patient is seen in ER on Sunday, has reduction of fracture and then admitted to Observation. On Monday Ortho doctor is called to consult on the pt in the Observation area, 99213. Ortho dr. decides the pt needs pinning sometime this week. The pt is discharged home from observation. The next day, Tuesday, the pt is seen in the Ortho clinic and the Ortho Dr evaluates pt again, 99213. Surgery is planned for Thursday of the same week.

    My question is can this doctor bill for his consult in the Observation and then again the next day in the clinic? He wants to bill 99213 for both visits.

    Thanks for your help!!


  2. #2
    Join Date
    Apr 2007
    Kansas City, MO


    Did your doc do the reduction? If so, isn't there a global period associated with that, and susbsequently no visits allowed at all.

    If he did not do the reduction, then he was called in for consult, the you can bill both visits. (maybe a new patient visit for the consult???)
    Linda Vargas, CPC, CPCO, CPMA, CPC-I, CEMC
    PMCC Licensed Instructor
    Kansas City, MO Chapter
    Member Development Officer 2016
    Harrisonville, MO Chapter President - 2013
    ICD-10 Education Coordinator- 2012
    Chapter President - 2011
    President Elect - 2010

  3. #3


    The ER doctor performed the reduction. I wish it was as simple as being in global. Thanks for your help!

  4. #4
    Join Date
    Apr 2007
    Milwaukee WI

    Default ER consult ONLY

    He only gets to bill for one pre-op visit, the one where he made the decision for surgery.

    He made the decision to perform surgery at the ER consult. Any visit after that is global to the surgery.

    Hope that helps.

    F Tessa Bartels, CPC, CEMC

Similar Threads

  1. Replies: 2
    Last Post: 03-20-2014, 03:43 PM
  2. Home visit and office visit same day, how do I code
    By nelstx2 in forum Medical Coding General Discussion
    Replies: 0
    Last Post: 12-27-2013, 02:31 PM
  3. Observation visit same day 2 providers
    By sknapp56 in forum OB/GYN
    Replies: 1
    Last Post: 06-08-2012, 08:48 AM
  4. Multiple day office consult
    By CHRISSYCODER in forum E/M
    Replies: 1
    Last Post: 03-19-2009, 02:46 PM
  5. Please help coding Office Consult/Minor Same day
    By Hopp in forum General Surgery
    Replies: 3
    Last Post: 02-17-2009, 08:10 AM

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?


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.