I work for an orthopedic surgeon in AZ. Our claims our getting denied using codes 99221-99223. Should we be using 99231-99233?? Please help
For Hospital consults you should be using codes 99241-99255. Unless the patient has medicare then you need to be using 99221-99223 with the AI modifier. But only if the patient has Medicare.
If patient does not have medicare then the 99221-99233 codes are for hospital admissions and subsequent hospital care only, not consults.
I work for an orthopedic surgeon in AZ. Our claims our getting denied using codes 99221-99223. Should we be using 99231-99233?? Please help
Unless your physician is the Admitting Doctor, you should not be using 99221-99223. The notes preceding the codes give very specific instructions on the use of these codes as they are for use by the admitting physician ONLY. If you doctor is consulting, then you would be using either 99251-99255 or the subsequent care codes 99231-99233.
Just a clarification, the original user stated that this is for Medicare, which does not allow 99251-99255 codes, have to use 99221-99223 instead, without the AI modifier, for a consult.