Consultation vs regular E/M

Hi there

we are working on denials and got a scenario as mentioned below.

Provider is same for both visits.

Initial visit was billed with 99244
subsequent visit was billed with 99205 in a span of barely a month.

I got the doubt that how come we bill 99205 for a subsequent visit.. i would like to correct it to 99215.. is this correct..

Please advise..

Thanks

re: Consultation vs regular E/M

Yes you are right.

re: Consultation vs regular E/M

Who is the payer? Medicare does not recognize consultation codes. The first visit is a new patient code and the 2nd visit is an established code. For other payers, check their policies.

re: Consultation vs regular E/M

Payer is Blue Shield of CA. Initial visit was billed as consultation (99244) and the subsequent visit was billed as regular E/M new patient (99205). So, i would like to bill subsequent visit as established pt with 99215. Advise please..