Cpt 99254...
Hi all,Can anyone help me to solve this ?Cpt 99254 is billed two times for an insurance company(cigna).One has been paid and another has been denied.In both the cases, referring provider is different,...
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If the provider performing the service is the same, it is a duplicate. Only one consult per hospital admission is allowed. Hope it helpsApril
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Can you give more details of why your provider performed two consults on the same patient during the same hospital admission? There are times when more than one consult could be appropriate,...
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Hi,The DOS is same and the provider performing is the same doctor only the referreing doctor is deifferent.regards,Jay.
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Most insurance companies pay for one consultation per day. Some limit the consultation to a specific number per year.Now the next question.... were the diagnoses the same or different. What was the...
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Hi steve,Yes the primary dx is same thats 786.50.But the second and the third Dx are different.its confusing !regards, JAy
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You still haven't told us the REASON for the consults. This is important to reaching the correct answer.Sharon
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Jay,You're really being rude by not answering our questions.Now, this whole thing smells fishy. You're coding two consultations for the same patient for the same day, for chest pain, simply because...
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If the patient was seen in the hospital and your provider is the consulting provider the consult 99254 you used would be fine. But, during this same hospital visit, if patient developed a new problem,...
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It's appropriate to bill a consult in any situation where a consult is requested. That said, I'm having a hard time coming up with any situation where a second consult on the same day would be...
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Nagahl: We STILL do not know if the consults were performed on the same day, or just during the same hospital stay, as the OP has not answered our questions.Sharon
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Yes we do. 5th post.Quote:Hi,The DOS is same and the provider performing is the same doctor only the referreing doctor is deifferent.regards,Jay.
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Hi all,Thanks for all your thoughts, We dont have much info here as to why the patient is being refereed ?situation is : Pt has the cpt 99254 two times with the same provider but the 2 referred...
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Jay,Its no inconvenience. We can only respond based on limited info presented and, as always, it presents an interesting discussion because others may come and have the same situation.Me, I say no to...
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Hi all,Thanks for all ur valuable thoughts ! like for ur thoughts in future too regards,Jay
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