fishercat29
New
Good day! Hoping someone can help shed some light on this for me. I work at a CAH Hospital billing Method II. My billing department has a Medicare claim where a patient was seen in observation on 10/21 and had a consult with the cardiologist to make sure he was stable for surgery. On 10/22 he was admitted as IP. The problem is the CPT used for when he was in Obs is 99222 Initial Hosp Care and Medicare is rejecting this because the day of service is a day before the admission to IP. I asked my coding manager about this and she states that "The consult codes are no longer used. So, if the consult was done in an o/p setting like obsv status it would be a 99202-99205. But the stay was changed to I/P, so the whole stay back to the time they were admitted out of ED to the hospital, it all goes to i/p charges. We still can bill for the obsv hours on the facility side, but all pro fees go to i/p codes."
This seems strange to me, but I am more biller than coder so I don't know if it is correct or not. Any advice is appreciated.
Thank you!
This seems strange to me, but I am more biller than coder so I don't know if it is correct or not. Any advice is appreciated.
Thank you!