CPT^® 99254, Under New or Established Patient

The Current Procedural Terminology (CPT^®) code 99254 as maintained by American Medical Association, is a medical procedural code under the range - New or Established Patient.

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Summary

The provider sees a patient for an inpatient or observation consultation involving evaluation and management (E/M). The E/M involves a moderate level of medical decision making or the provider spends at least 60 minutes of total time on the encounter on a single date.

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Claim denials from Blue Cross

We have recently been receiving requests from Blue Cross Blue Shield for us to refund money to them. Our doctors cover the pulmonary patients on the floor at our local hospital, we bill for their visi... [ Read More ]

99223

[QUOTE="heart123, post: 495125, member: 69639"] i guess im not explaining my question right, My Dr does a consult in the hospital I know i cant use 99254 for some insurance sooo can i use 99223??? ho... [ Read More ]

99223

i guess im not explaining my question right, My Dr does a consult in the hospital I know i cant use 99254 for some insurance sooo can i use 99223??? hope i explained it better lol Thanks... [ Read More ]

UHC Consultation Policy

If the service rendered at inpatient setting, then we can bill appropriate admit CPT code, based on the level supported in document. Just assume, the service performed inpatient consult and document... [ Read More ]

23 hr observation in ICU?

[QUOTE="heartyoga, post: 449940, member: 220860"]We are an independent practice from the hospital, so we sometimes have difficulty communicating with hospital if they change the status of patient stay... [ Read More ]

23 hr observation in ICU?

We are an independent practice from the hospital, so we sometimes have difficulty communicating with hospital if they change the status of patient stay from inpatient to 23 hr observation or vice vers... [ Read More ]

99254 initial consultation and next day 49204 surgery with mod 80 denied

My provider was on call at a facility and looks like he saw a pt for initial consultation. The next day he assisted in surgery for this pt. Aetna denied the 99254 as global and the 49204 reason denial... [ Read More ]

99254

Hello Do any payers still cover the inpatient consultation code 99254? Thank you... [ Read More ]

Can't get 99244/99254 reimbursed from MCR!!!!

Anyone know of another CPT code I can use in place of the 99244/99254. Can't get MCR to pay for these Consultation visits at the hospital. POS is 21.... [ Read More ]

CANPC Anesthesiology coding essentials book 62 p. (61-70)

CANPC Anesthesiology coding essentials for successful anesthesiology coding by Vino C. Mody Jr., M.D., COC, CPC, CCS-P, CANPC, CCVTC Case 61 Postoperative Diagnosis: Heartburn Diverticulosis of the c... [ Read More ]

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