Forum - Questions & Answers

Aug 17th, 2015 - kurban

Inpatient consultations

I know that the consult codes are no longer used by private insurances. I thought that we were to use E&M codes, but I have a denied claim saying 99204 is not valid for POS 21. Is this correct? If so, what codes should be used for inpatient consults? Thank you

Aug 17th, 2015 - petunia 195 

re: Inpatient consultations

If you are billing impatient then your code should reflect that as well. 99204 would only be used in a OH/OF location. Your code should cross to inpatient visits.

Aug 18th, 2015 - rphelps 615  1 

re: Inpatient consultations

99221-99223. I still bill consult codes to everyone with the exception of Medicare and Cigna.

Aug 18th, 2015 - ginasn 12 

re: Inpatient consultations

If you are billing an inpatient consult, then the code range is 99251-99255. Medicare, and Indiana Medicaid do not accept these codes, so you would have to then change to initial inpatient code, range 99221-99223.

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