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99205 after previous transfer of care billed with 99233

Sheila Posted Wed 01st of June, 2011 18:31:41 PM

My Neurologist saw pt in hosp follow-up (99233)while covering for another neurologist on 2-10-2011. DX was acute ataxia. Now pt comes in to consult as out-pt on 5-31-2011 with similar problem. Can this visit be billed as 99205, or does it have to be 99215, inspite of a full neurology consultation being done ? The doctor wants to bill for the 60+ minutes as a 99205


Nikhil Answered Wed 01st of June, 2011 21:30:54 PM

Who is the 2nd physician in this case?

Sheila Posted Thu 02nd of June, 2011 02:55:37 AM

Both physicians are neurologists who cross-cover hosp pm and weekend calls. Each w/ a seperate practice & tax IDs. The neurologist who saw pt on 5-31-11 in out-pt ofc place of svc has never billed a cons code, just rounded on Physician # 1's in-patient earlier in Feb.


SuperCoder Answered Thu 02nd of June, 2011 13:46:20 PM

There are numerous definitions and articles that would tell you that the patient here is an established patient, hence be coded 99215.

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