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Making Inpatient Reporting Easy

Making Inpatient Reporting Easy

One of the most difficult medical billing feats is inpatient consultation coding. There are many instances when a follow-up inpatient consult should be replaced by a subsequent hospital care visit. To eliminate these medical billing errors, there are four facts to consider when coding for inpatient consults.

The first fact is very obvious. If your report an inpatient consultation exam, the patient must be inpatient, not outpatient. Very often physicians see patients on a consultation basis when they are outpatient. Medical billing mistakes can be made easily. Double check your work.

It is important in medical billing to always report one initial consultation. This code will correspond with the very first meeting between the physician and the patient. The medical billing codes to use are 99251-99255. If the patient is discharged and then readmitted, remember that another initial inpatient consultation code may be reported.

The third point is to make sure subsequent same stay consults are allowed. There are two rules that deem additional consults necessary. First, the doctor sees the patient again because he/she was not able to finish the consult the first time. Second, if the attending physician requests a second consult due to changes in medical condition. The medical billing codes to use for subsequent inpatient consults are 99261-99263.

The final part of inpatient consult coding is to rule-out subsequent hospital care. If your physician assumes responsibility for a patient’s care after the initial consult, you should not report additional consult codes for that stay. Instead, the correct medical billing policy is to bill subsequent hospital care codes 99231-99233.

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