If you do inpatient consultations (99551 to 99255) or outpatient consultations (99241 to 99245), please see the informational links below.  Our interpretation of the documentation requirements for each new code is included.  Only use the modifier if you are the Attending Physician.

If your documentation does not meet minimum requirements for the new patient visits, it is our guess that you would then default to the established patient visit codes, but we have sent a question to Medicare requesting verification of this.

While this information has been carefully reviewed, we take no responsibility for its contents.  We recommend you have the information carefully reviewed by your biller.

Hospital and Outpatient Codes Replacing the Consultation Codes

Commentary from the American College of Chest Physicians