Author Topic: Problem Billing  (Read 1218 times)

suzyd

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Problem Billing
« on: August 08, 2012, 11:10:20 AM »
Am not clear how to bill a consult by my gastroenterologist for a commericial insurance when the patient is admitted for observation

Michele

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Re: Problem Billing
« Reply #1 on: August 08, 2012, 02:04:47 PM »
Do you mean as far as what POS?
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suzyd

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Re: Problem Billing
« Reply #2 on: August 08, 2012, 04:15:28 PM »
No  more which cpt codes to use.  Do I use outpatient consult codes or outpatient E & M as I do for medicare

Michele

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Re: Problem Billing
« Reply #3 on: August 13, 2012, 08:17:28 AM »
I wouldn't be able to tell you which CPT code to use based on what you've said.  The provider needs to tell you whether they did a visit, or a consultation.  If the place of service is in a hospital then you wouldn't use the outpatient E&M, you would have to use hospital codes.  However, take note that Medicare no longer reimburses for consultation codes.
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