Author Topic: outpt consult then inpt f/u  (Read 1352 times)


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outpt consult then inpt f/u
« on: September 25, 2009, 10:37:05 AM »
If we have seen a new consult in the office (99254) then the patient gets admitted to the hospital and we are reconsulted within 3 years for the same issue at that inpt stay, how do I bill it?  I have tried a 99233 and it went through with Medicare but they wouldn't pay a 99215 with the place of service 21, which someone told me was how I was supposed to bill it.  Medicare won't pay a 99354 extended time code on a 99233 so we only got paid for part of our time.  So what happens when you spend 60-80 minutes on an inpatient consult in a patient who is known to you from you office? I would be very greatful for any advice.


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Re: outpt consult then inpt f/u
« Reply #1 on: September 28, 2009, 05:39:31 AM »
The 99215 definitely isn't correct with the 21 POS since the definition of the 99215 is 'office'.  There really isn't any other code that is appropriate.  Most carriers have rules as to the frequency of consults for the same condition.  You really have to code it for what it is and if it's not covered, it's not covered.


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