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Wiki Code 99203 vs 99243

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melstone

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what are the guidelines for billing 99203 vs 99243. if a pcp refers pt to specialist (podiatry) which code is appropriate to bill?
 
If the insurance company accepts consultation codes (many that follow CMS do not and want 992XX codes) It must meet the 3 R's. If its a transfer of care, its not billable as a consultation

A consultation is performed when a physician is asked to render an opinion to be used by the attending physician in the treatment of the patient. A written report back to the requesting physician.

Transfer of care from one physician to a second physician when the second physician assumes responsibility for treatment of the patient.
 
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