Wiki observation HELP PLEASE

[DRBasel1045]

I have a pt that we need to bill out, pt was admitted to the hospital as OBSERVATION STATUS because of Weight loss and Vomiting. Our physcian was called in for a consult for Abdominal pain, nausea and Vomiting. The pt is United healthcare Medicare Complete, so we can not bill out the Consult codes, I have always billed out if a NP the 9920X and then any subsequent visits as 9921X. We have a new Billing follow up person in our department with Coding certification and she is telling me we can not bill these out and is suggesting that we use the 99218-99220 codes and 99234-99236. I was always under the understanding that these codes could only be used by the admitting physician?

Can someone please give me some advise on this

Thanks
Dawn

 

[djlukes49]

Our doctors are specialists, too, and get called in to consult for pts in observation. We bill the way you do (new pt code, established pt code for followup) for Medicare, Medicare replacements, and many commercial insurances that no longer accept consultation codes. We do not get rejected for this. I too believe that the codes your other coder is referring to are codes for the admitting doctor. If we're wrong, I hope someone corrects us.

DJ