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What is medical code 99255?

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Anonymous

15y ago
Updated: 8/17/2019

what is medical code 99255

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15y ago

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What does CPT code 99245 stand for?

It stands for CONSULTATION SERVICES, but as of January 1, 2010, Medicare no longer recognizes CPT codes for consultation (CPT codes 99241-99245 and 99251-99255).


What is cpt code 99255?

CPT Code 99255 - Inpatient consultation for a new or established patient, which requires these 3 key components:A comprehensive history;A comprehensive examination; andMedical decision making of high complexity.Counseling and/or coordination of care with other providers or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs.Usually, the presenting problem(s) are of moderate to high severity. Physicians typically spend 110 minutes at the bedside and on the patient's hospital floor or unit.


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What cpt code is used for hospital consult?

That would be the Inpatient Consultation codes 99251 through 99255. However, effective 2010, Medicare stopped reimbursing consult codes 99241-99245 (outpatient consults) and 99251-99255 (Inpatient consults). Medicare must be billed with Initial Hospital Service codes 99221-99223. In addition, the primary physician of record (PPOR) who admits the patient must continue to use those same codes and append the modifier AI to the code. Services on subsequent days would be billed by both PPOR and consultant using Subsequent visit codes 99231-99233.


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