Medicare consult. Can someone break it down with pos for me?

I am unclear how to bill medicare for consult performed in the hospital. I need help on POS too. Can someone break it down for me. I need help with if the patient was seen in hospital est and new; plus POS to use? Also, if patient was not admitted in hospital what code to use for est and new; POS to use... Can you please help me or point me in a direction to find what I need... Here is example. I charged 99222 POS 22 because patient was in hospital for 3 days. Medicare denied for incorrect POS... Thanks guys

re: MEDICARE CONSULT. CAN SOMEONE BREAK IT DOWN WITH POS FOR ME?

Well if the PT was admitted you should use POS 21.
22 is out patient. Medicare does not accept consult codes, so you would have to look at the subsequesnt care codes. Do you have A CPT® book?
All your POS codes are there as well as the hospital codes, I suggest starting at around page 14 and read all your guidelines...this should help. Also try the CMS website for more info on the "consult" codes.

re: MEDICARE CONSULT. CAN SOMEONE BREAK IT DOWN WITH POS FOR ME?

[I am unclear how to bill medicare for consult performed in the hospital. I need help on POS too. Can someone break it down for me. I need help with if the patient was seen in hospital est and new; plus POS to use? Also, if patient was not admitted in hospital what code to use for est and new; POS to use... Can you please help me or point me in a direction to find what I need... Here is example. I charged 99222 POS 22 because patient was in hospital for 3 days. Medicare denied for incorrect POS... Thanks guys]

We always bill consult codes from our general surgery doctors and we have no problem with Medicare as it always got paid. Here's what we use.


99222-9223 for inpatient consultation (21)
99231-99233 for follow-up visits (21)
99218-99220 for outpatient/observation consultation (22)

Now we have not tried billing for follow-up visits on outpatient or observation. You might want to look at these codes 99224-99226.

Hope that helps.