CPT Q&A

Q:I am a consultant to physicians at a nursing facility, who call me in when they think a resident may be having psychiatric issues. How do I code for these services? Do I use nursing home codes or consultation codes? If I use consultation codes, do I use the ones for outpatient or inpatient?

A: The proper codes to use for a consult in a nursing home are the inpatient consultation codes (99251-99255 for new patients; 99261-99263 for established patients). For the purposes of consultations, nursing facilities are considered inpatient settings. It is important to note that when a consultation code is used, you must submit a written report to the referring physician. ▪