Forum - Questions & Answers

Sep 11th, 2014 - ravip3366 19 

IP Initial Consultation 99223/99233


Anybody can help out for the following scenario:

Patient X has a hospital episode three months back and our Dr has seen him for the first time and we have billed 99223 for his consultation.

Now, the patient is again admitted for severe illness and the Dr did a consultation.

My doubt is whether to use Initial Consultation codes or Subsequent Consultation codes for this service.

Please advise and thanks in advance.

Sep 11th, 2014 - cardio13 2 

re: IP Initial Consultation 99223/99233

I would use the Initial Consultation 99223, this is a different admission.

Oct 2nd, 2014 - ravip3366 19 

re: IP Initial Consultation 99223/99233


Thanks for your advise..

And, I have one more doubt..
If Dr. A covers a pt of Dr.X in the same episode, should Dr. A bill initial consultation (because the pt is new for him) or go with subsequent consultation?

Got doubt, because Dr. X has already visited first and might have billed initial consultation for his visit. Then Dr. A visited the pt to cover in the absence of Dr. B.

And, most importantly though both doctors are of same specialty, not of the same group per Medicare records.

Please advise; and thanks in advance.

Oct 3rd, 2014 - LBAROGIANIS 250 

re: IP Initial Consultation 99223/99233

If the doctors are in the same speciality only one dr can bill per day. So if dr (a) saw the patient first, he gets to bill the intial visit.. If dr (b) saw the patient the next day, he has to bill subsequent visits... There should be only one specialist in any one catagory seeing this patient. Ex: neurology--you can't have two neuros seeing the same patient.

oh and if the patient comes back to the hosptial then the initial visits starts all over.. One initial visit per stay then the rest are subsequent.

sorry forgot about the caps rule.. Will try to remember next time.

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