Im still very confused about the inpatient “consult.” If we have seen the patient for anything in the past 3 years, we must use Established codes?
The three year rule is only applicable for office or outpatient E/M services. When a consulting physician is requested to see a patient in the hospital, they should bill the inpatient admission codes (99221-99223). If the consulting physician continues to see the patient during a specific hospital stay, then the physician would bill the subsequent hospital codes (99231-99233).
- When a new patient is seen as an inpatient with a practice, when they are seen at the clinic for the first time isn’t that patient still considered a new patient visit?
- If a patient is seen in the hospital previously, say 6 months ago and we are called in to consult, is that considered an existing patient?
- How do I know where to refer a Tufts Health Plan patient for inpatient or partial hospitalization?