Wiki Medicare Obsveration consults

[slampp]

How do I bill for an observation consult for a medicare patient. We keep running into issues where 99218 -99220 gets denied only the admitting physician can bill them and 99241 - 99244 are denied because they are consulting codes and medicare does not pay these.

HELP!!!

 

[RebeccaWoodward*]

How do I bill for an observation consult for a medicare patient. We keep running into issues where 99218 -99220 gets denied only the admitting physician can bill them and 99241 - 99244 are denied because they are consulting codes and medicare does not pay these.

HELP!!!

Payment for an initial observation care code is for all the care rendered by the ordering physician on the date the patient’s observation services began. All other physicians who furnish consultations or additional evaluations or services while the patient is receiving hospital outpatient observation services must bill the appropriate outpatient service codes.


For example, if an internist orders observation services and asks another physician to additionally evaluate the patient, only the internist may bill the initial and subsequent observation care codes. The other physician who evaluates the patient must bill the new or established office or other outpatient visit codes as appropriate.

Page 52

http://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/clm104c12.pdf

 

[staticsis2]

We bill if it is out patient New patient codes (if new to our practice 99201-99205 ) and if establised
99212-99215 with location 22 out patient. Hope this helps