Wiki Inpatient visit help

[egraham1827]

If an established patient is seen as Inpatient for a new problem are you able to code a new consult code, even if the patient was seen less than 3 years ago? I vaguely remember reading something that says even if the patient is established with the provider/practice you may still bill an inpatient consult code. OR do you have to use the inpatient follow up codes? Any guidance or link to this info would be great!

Thank you!

 

[Orthocoderpgu]

Use code range 99221 through 99223 for the first visit.

Keep in mind that a "Consultation" is a physician asking another physician for help with a patient. CMS found out that 95% of consultation codes billed were not billed correctly for three consecutive years (Request, Render, Report). That's why CMS will no longer process consultation codes and many private companies have followed that lead.

 

[Kris78]

New/Established does not apply to inpatient Hospital Consult or H/P.
New problem or not, if a provider is consulting on an inpatient patient for that given admission then it will be "new".

If it was an outpatient, then the "established if seen within 3 years" would apply.

 

[CodingKing]

New/Established does not apply to inpatient Hospital Consult or H/P.
New problem or not, if a provider is consulting on an inpatient patient for that given admission then it will be "new".

If it was an outpatient, then the "established if seen within 3 years" would apply.

Outpatient it will depend if using the consult CPT codes or the normal office visits codes for those payers that don't accept the consultation codes.