kfrycpc
Guest
IBC is denying consult code 99254 and place of service 21 for a consult service that was during a patient's observation stay. The provider actually saw her in the emergency dept. What code should be used?
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Wiki Billing A Consult In An Observation
- Thread starter kfrycpc
- Start date
mhstrauss
True Blue
POS for ED is 23, and the ED consult codes are 99281-99285.
kevbshields
Guest
Observation is an outpatient service, meaning your E&M code is incorrect right off. Too, Observation is a status, not a physical location.
99241-99245 are consultations that occur in the outpatient area (including the ER).
99241-99245 are consultations that occur in the outpatient area (including the ER).
kfrycpc
Guest
Thank you Kevin. Incidentially, this payer was Medicare who does not accept consult codes. So what should we use instead?
kevbshields
Guest
You must then "crosswalk" or level your code to the 99201-99215 series, based on the latest guidance.