Wiki Removal of Peg tube charges

[ChristineA]

When billing for a peg removal I know that there is no specific code so we bill it as a consult but if the patient has medicare what code are you guys using? When reading 99201-99205 it looks like it is for a New patient only do you then used the established patient codes 99211-99215? I guess I am a little confused because under the codes 99241-99245 it says that if an additional request for an opinion or advice regarding the same or a new problem is received from another physician or other appropriate source and documented in the medical record the office consultation codes may be used again. I think I am confusing myself but any in put would be helpful. Thanks

 

[koatsj]

Medicare has done away with consult codes since 2010 I believe. You will need to bill out the appropriate new patient/established patient code for your outpatient visits.

 

[ChristineA]

So do you bill your peg tube removal under the new patient codes 99201-99205 or under the established patient codes? I have always been told to bill as a consult but is that correct since we placed the tube and do all the changes is it correct to bill under consult or established patient

 

[koatsj]

You cannot bill out consult codes for Medicare. If the patient has been seen in the last three years, the patient is considered established and you will then need to bill out the appropriate E/M code for the visit.