Wiki subsequent visit help!!

[asasands]

If one of our physicians sees a patient in the hospital for a consult and uses E&M codes 99251-99255 and sees them again the next day, can we use those codes again? Or do I need to use 99231-99232. We are not the admitting physician. One of my surgeons think if we are not the admitting physician we can use codes from 99251-99255 throughout the entire hospital stay. Can anyone please help me? Is there any instant we can use them every day throughout the stay?

Thanks

Stacey

 

[cnoel79]

99251-99255 is only used for consults...the subsequent codes should be used if they are still seeing the pt for a problem. it does not matter that he is not the admitting..hope this helps!!

 

[MarcusM]

Once your doctor has been called in for a consult on a specific problem, then he becomes the "treating" doctor for that problem so subsequent visits are not consults. In your outpatient practice, does your "consulting" doctor bill all subsequent visits as consults as well? Check out this article:
http://www.nmmlaw.com/pdf/broskeeper.pdf

 

[asasands]

subsequent visits

Now I am confused. Are you saying if our physician was called in to consult for abdominal pain..we would bill 99251-99255 for the first initial consulation (not medicare patient) that on the next day we follow up on the abdominal pain we could use codes from 99251-99255 again?

Stacey

 

[MnTwins29]

Now I am confused. Are you saying if our physician was called in to consult for abdominal pain..we would bill 99251-99255 for the first initial consulation (not medicare patient) that on the next day we follow up on the abdominal pain we could use codes from 99251-99255 again?

Stacey

No, only the first visit can be billed as a consultation. It was said in an earlier response, but worth repeating - any subsequent visits indicate your physician has assumed care for that condition for which he was called in consultation. Therefore, the subsequent hospital codes are used for the follow up visits.