Practice Management Alert

Question: If my doctor sees a patient in the office for something like diabetes, then the patient is admitted for something else and the admitting physician consults my doctor about the diabetes, is it a new consult? Alabama Subscriber Answer: In this case the coding would depend on the payer’s consultation rules. If following Medicare rules, in-hospital consultations are billed with the initial hospital visit code 99221-99223 (Initial hospital care, per day, for the evaluation and management of a patient …) whether the patient is old or new. The same holds true if the payer follows CPT® rules. In-hospital consultations would be billed with the older CPT® codes 99251-99255 (Inpatient consultation for a new or established patient …) whether the patient is a new or old patient. All this assumes that consultation requirements are met. If there is no consultation requested, and the admitting physician only wishes your provider to also follow the patient for [...]