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Intraoperative consult code?

  1. #1
    Location
    St Louis West Missouri Chapter
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    79
    Default Intraoperative consult code?
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    One of my surgeons "scrubbed in" on a co-surgery but the surgery code was not one that can be billed with a 62 modifier; so my surgeon is wondering if he can charge an intra-operative consult code?
    I have looked in the cpt code book; I have Googled; and I have had no success finding an "intraoperative consultation code," with the exception of Intraoperation codes for Surgical Pathology.
    Does anyone have any ideas regarding intraoperative consult codes that could be used for the purpose I described? Any thoughts would be greatly appreciated!

  2. #2
    Location
    Tacoma, WA
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    1,087
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    I would use an In-patient Consultation code in the 99251-99255 range, or one of the Subsequent Hospital care codes in the 99231-99233 range. Either would work for the situation you describe.
    Arlene J. Smith, CPC, CPMA, CEMC, COBGC

  3. Default
    Arlene, How about this situation we are an Orthpaedic Group who just added a PM&R. One of the surgeons done a Total hip replacement on a patient once discharged to inpatient rehab our PM&R who is part of our group done what he called a evaluation of the patient & review of patient therapy & progress & said he can bill a inpatient consult & subsequent hospital care while he follows the patient for the surgeon. I explained due to the fact we bill as a group & each provider is part of this group this would be part of post-op care & not billable? Could this be billable & if so I'm sure it could not be inpatient consult nor seq care is there anyone code or anyway this could be bill or am I right & it doesn't matter if the PM&R is a diffrent speciality because they practice in the same group?

  4. #4
    Location
    Concord, NC or Rochester, NY
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    154
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    Before I bill anyting, it is important to understand the necessity of your surgeon scrubbing in. Normally a hip replacement is a single surgeon surgery - therefore why was it necessary for your surgeon to be there. Medical necessity should be the driving factor. If your surgeon is from a different specialty and was required to provide advice for patient care, then it probably could be billed

  5. #5
    Location
    Tacoma, WA
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    1,087
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    Quote Originally Posted by jweaver@carolinaortho.org View Post
    Arlene, How about this situation we are an Orthpaedic Group who just added a PM&R. One of the surgeons done a Total hip replacement on a patient once discharged to inpatient rehab our PM&R who is part of our group done what he called a evaluation of the patient & review of patient therapy & progress & said he can bill a inpatient consult & subsequent hospital care while he follows the patient for the surgeon. I explained due to the fact we bill as a group & each provider is part of this group this would be part of post-op care & not billable? Could this be billable & if so I'm sure it could not be inpatient consult nor seq care is there anyone code or anyway this could be bill or am I right & it doesn't matter if the PM&R is a diffrent speciality because they practice in the same group?
    So this new provider is a Physical Medicine and Rehab specialist right. Because they are of a different specialty than the provider who performed the surgery and they are beginning the process of rehabing the patient after the surgery, they can bill an in-patient consult and subsequent care. They are not providing routine post op care, they are designing a post surgical rehab program. If the patient is on Medicare, you cannot use the consultation codes, but are allowed to use the other hospital in patient codes as appropriate.
    Arlene J. Smith, CPC, CPMA, CEMC, COBGC

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