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Consultation codes

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Rich:
If I see a new patient for consultation in the hospital and use CPT 9925x and then see the same patient a week later in my office (but the patient is new to my office) do I use CPT 9924x or do I use 9921x?
Thanks very much.
-Rich.

Michele:
That's a good question, hmmmmmm.  Wow, I really had to stop and think.  I haven't personally been faced with that situation before, but I think that you can bill for the new patient visit in the office since the patient has not been seen before by you for a complete history and physical.  The consultation in the hospital was for a specific illness/situation and the office visit is a more complete history and physical.

If anyone has experience with this and I'm not correct, :( please let us know!

Michele

FBbilling:
As far as I know because you have seen the patient this would make them an established patient so it would be a 9921x

Rich:
Thanks Michele and FBbilling. I appreciate your responses, but unfortunately, I'm still unsure on how to proceed.

If I am a PCP and get an unassigned patient admitted to the hospital on my service, I see them and discharge them and then have them follow up with me in my office- is my office visit 20x or 21x.

If I am a consultant and I do an inpatient consult on a patient who upon discharge is referred to my office for follow up- is my office visit 24x or 21x?

Any help is greatly appreciated.
-Rich.

Michele:
I think that if you see a patient in the hospital for a consult and then the patient comes to the office for a follow up on the same condition I would bill it as a 9921*.

Michele

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