Consult Billing
Curious how other PM&R groups are handling this situation because administration is pushing our group to explore interprofessional consult billing for remote rehab reviews, and there is concern about whether it is actually possible given CMS inpatient rehabilitation facility rules.
The specific scenario is:
PM&R reviews a patient for inpatient rehabilitation appropriateness,
recommendations are communicated back to the primary team,
the patient is ultimately determined to NOT be appropriate for inpatient rehabilitation,
no inpatient rehabilitation admission occurs, and
no face-to-face PM&R encounter subsequently takes place.
Given that inpatient rehabilitation preadmission screening is considered part of the inpatient rehabilitation payment structure when a patient is admitted, but the gray area that admin believes this works seems to be denied/non-admitted patients where no inpatient rehabilitation payment is ever generated.
Are any groups billing interprofessional consult codes (99446-99451) in this situation, or are most groups treating these as non-billable utilization review/admission screening activity regardless of admission outcome?