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Inpatient consult w/hearing test denial for place of service

Francisco Posted Wed 28th of September, 2011 13:57:25 PM

Initial consult '99221-25' with audio '92557', '92567' done in office setting denied for place of service. It was coded as inpatient hospital. Our office is connected to the hospital, but patient was transported to the office for consult and testing. Should this be coded as office visit when the patient is in the hospital?

SuperCoder Answered Wed 28th of September, 2011 17:19:33 PM

The question remains in whose Tax Id the patient is going to be billed? From Admission to Inpatient till Discharge, the patient is "Inpatient" in written. During this time all the consultations provided are Inpatient, even if physically provided outside the hospital by the Consulting physician, and so can be billed on Hospital's Tax ID.
But, it is not always compulsory to be billed under Hospital's Tax Id. The Physician also has the option of billing the service on his own Tax ID (eventhough the patient is registered as Inpatient at that point of time).
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If at the time of consultation the patient is registered as an Inpatient, and the Consultation provided is at the Hospital Tax ID (even though physically outside the hospital), then the POS would be 21 here.
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If at the time of consultation the patient is registered as an Inpatient, and the Consultation provided is at the Physician's Tax ID (physically outside the hospital), then POS would be 22.

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