Problem Billing

[suzyd]

Am not clear how to bill a consult by my gastroenterologist for a commericial insurance when the patient is admitted for observation

[Michele]

Do you mean as far as what POS?

[suzyd]

No  more which cpt codes to use.  Do I use outpatient consult codes or outpatient E & M as I do for medicare

[Michele]

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.