Wiki E&M questions please help

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If we have a patient that we have been treating for an ongoing problem, and they are admitted to the hospital by their PCP for a general medical problem, and then we are called in to see the patient for the same problem that we have been treating them in our office. Are we able to bill a consult or would we bill for a subsequent hospital visit. This would be a Medicare patient by the way since you can not charge a consult on Medicare patients.
Please help i just need clarification on this.
:)

Thank you

You can also e-mail me at jnninso@yahoo.com.
 
medicare does not allow consults

Hi

Medicare does not allow consults. If the physician is seeing the patient for the first time in the hospital, and no one in the same specialty has seen the patient in the hospital, you would bill an intial hospital visit (99221-99223), established problem.
 
You would bill an initial hospital visit. Even though you may not bill a consultation code, and whether or not you meet the criteria for a consult is irrelevant, because specialists may bill the Initial hosptial visit an evaluation visit with the patient during that admission.

CMS Publication 100-4, Chapter 12: 30.6.10 - Consultation Services (Codes 99241 - 99255)
(Rev. 1875, Issued: 12-14-09, Effective: 01-01-10, Implementation: 01-04-10)

"In the inpatient hospital setting and the nursing facility setting all physicians (and qualified nonphysician practitioners where permitted) who perform an initial evaluation may bill the initial hospital care codes (99221 – 99223) or nursing facility care codes (99304 – 99306). The principal physician of record is identified in Medicare as the physician who oversees the patient's care from other physicians who may be furnishing specialty care. The principal physician of record shall append modifier “-AI”, Principal Physician of Record, in addition to the E/M code. Follow-up visits in the facility setting shall be billed as subsequent hospital care visits and subsequent nursing facility care visits. ). "
 
We are the Cardiologist for the patient.
jelkins said:
If we have a patient that we have been treating for an ongoing problem, and they are admitted to the hospital by their PCP for a general medical problem, and then we are called in to see the patient for the same problem that we have been treating them in our office. Are we able to bill a consult or would we bill for a subsequent hospital visit. This would be a Medicare patient by the way since you can not charge a consult on Medicare patients.
Please help i just need clarification on this.
:)

Thank you

You can also e-mail me at jnninso@yahoo.com.
Click to expand...
 
E/M code for 2013

I need help
E/M code 2013 is there a specific e/m code to use after our physician saw the patient at the hospital coming in the office for the first time for a follow up?? :(

Thank you
 
How does a hospitalist fit in to the equation, as PCP are not admitting so much anymore? Would the hospitalist use AI?
 
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