consult codes

What code is a consult physician seeing a patient for the first time in hospital observation setting suppose to use?

Obs

Office codes 99201-99215

consult codes

Thanks!

Billing observationa consults

Wouldn't they bill Office and Outpatient Consultation codes 99241-99245 (unless it's Medicare)?

Carriers only pay for initial observation care billed by the physician who admitted the patient for observation and who was responsible for the patient during his/her stay. A physician who does not have inpatient admitting privileges but who is authorized to admit a patient for observation status may bill these codes.

For a physician to bill the initial observation care codes, there must be documentation of dated and timed physician’s admitting orders regarding the care the patient is to receive while in observation, nursing notes, and progress notes prepared by the physician while the patient was in observation status. This documentation must be in addition to any record prepared as a result of an emergency department or outpatient clinic visit.

Payment for an initial observation care code includes all the care rendered by the admitting physician on the date the patient was admitted for observation. All other physicians who see the patient while he or she is in observation must bill the office and other outpatient service codes or outpatient consultation codes, as appropriate, when they provide evaluation and management services.

For example, if an internist admits a patient for observation and asks an allergist for a consultation on the patient’s condition, only the internist can bill the initial observation care code. The allergist must bill using the outpatient consultation code that best represents the services he or she provided. The allergist cannot bill an inpatient consultation since the patient was not a hospital inpatient.

Non-Medicare

Yes, they would, my mind runs to Medicare first!!
Thanks

Billing observation consults

As does most all of us...I tell my docs "it's Medicare's world, we're just trying to exist compliantly in it."

Thanks,
Carole