Wiki Observation Status Initial Visit

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kathleenw84

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I and my copartner in GI coding both do this differently. Here is the scenario:

Our MD is on call at the hospital asked to see a patient that is established with the practice that has been admitted on observation status.

So, is it correct to code E/M established patient office visits codes, or, since we cannot use initial hospital visit codes for an inpatient status, do we cross reference the codes to E/M new patient codes. Which is correct?
 
We are asked to see patient to "consult" on patient. Although, you are right. If it is a self pay patient we could use a consult code. Commercial insurance here in SW Michigan seem to all follow the Medicare rule of consultation codes as out of business so to speak. So, if we are not allowed to use consult codes (99.9% of time), I code with NP codes since the status of patient in the hospital denies if I use 99221-99223. Oh dear!
 
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Established patient

If it's an established patient, it's an established patient.

You MAY be asked for a consultation, but if your carrier doesn't accept the consult codes you are left with OP visit, established (POS 22)

Hope that helps.

F Tessa Bartels, CPC, CEMC
 
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