Wiki Surgical procedure and consultation coding

codeseeker

Guest
Messages
15
Location
New York, NY
Best answers
0
I have a doctor who bills for surgical procedures (such as extraction of kidney stones) and then sees the patient on subsequent days in the hospital (as an inpatient). He wants me to code the first follow-up visit as an inpatient consultation rather than using a subsequent inpatient visit code. Is this legitimate? For example, the surgical intervention is on day 1, shouldn't the follow-up on day 2 be coded as a subsequent inpatient visit rather than an inpatient consultation? I thought that inpatient consultation codes are reserved for the initial encounter, but in my case, the initial encounter was already on the day of the surgical intervention?
 
If the physician did a consultation prior to the procedure, you would bill an appropriate consult (E/M code) with modifier 25 or 57 (whichever is needed). If the procedure has no PO days, then you can bill a subsequent visit on day 2. If it has PO days, then there would be nothing to bill to insurance.
 
Top