Coding > Coding

Problem Billing

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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.

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