Pulmonology Coding Alert

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


New Hampshire Subscriber


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

If your pulmonologist admits the patient to the hospital on the same day, however, you should more accurately report his service with the applicable hospital admission code (99221-99223, Initial hospital care, per day, for the evaluation and management of a patient ...).

Only the physician who admits the patient to observation can bill the observation admit codes (99218-99220, Initial observation care, per day ...) per observation stay. Answers for You be the Coder and Reader Questions were reviewed by Carol Pohlig, BSN, RN, CPC, senior coding and education specialist at the University of Pennsylvania department of medicine in Philadelphia; and Alan L. Plummer, MD, professor of medicine, Division of Pulmonary, Allergy and Critical Care at Emory University School of Medicine in Atlanta.