Dermatology Coding Alert

Reader Questions:

Charge Outpatient Consult for Observation

Question: Another doctor asked my dermatologist for a consult with a patient who had been admitted for an observation stay. Should I use 99218-99220?


New Hampshire Subscriber


Answer: Because your dermatologist is involved with the patient in a consultative capacity, you should report his services with the appropriate outpatient consultation code (99241-99245, Office consultation for a new or established patient...).

If the consulting physician advises the primary-care physician to admit the patient, and this subsequently occurs on the same day as the consult, then the consulting physician should bill for an inpatient consultation (99251-99254, Initial inpatient consultation for a new or established patient...).

If the consulting physician assumes care and decides to admit the patient, then code the service with the applicable initial inpatient care code (99221-99223, Initial hospital care, per day, for the evaluation and management of a patient...).

Only one physician can bill the observation admit codes (99218-99220, Initial observation care, per day ...) per observation stay. Because observation is an outpatient setting, all other physicians treating the patient in observation should report outpatient care codes.

 

Other Articles in this issue of

Dermatology Coding Alert

View All