Forum - Questions & Answers

Sep 27th, 2009 - akopian 28 

asked for re-consult.

I saw a patient in the hospital for small bowel obstruction (hospital consult). Patient did fine without any surgery (therefore no global) and went home. He was re-admitted by the primary 1 month later for the same symptoms and again I was asked to consult. I know this has been asked before (and my apologies for asking again), but how would the second consult be coded...is this a hospital consult again (keep in mind its for a recurrence of the same problem) or is this an established hospital visit? (Assume that all of the documentation requirements for consultation are met). Thanks.

Sep 27th, 2009 - nmaguire   2,606 

consult

Medicare allows one consult/hospitalization.

Sep 27th, 2009 -

She really means

One consult per hospitalization per doctor. Bill another consultation!

Sep 28th, 2009 - Codapedia Editor 1,399 

consults

If the conditions for a consult are met: request, reason, report: then you can bill a consult because it's a different hospitalization. Consults are divided into outpatient/office and inpatient, not new and established.

If the patient was in the same admission, then only a subsequent hospital visit.

Some surgeons (and other specialists) only bill level 4 and 5 consults, because they were taught to do a comprehensive history and exam on every patient. Here's the perfect time to bill a level three consult, and add some variation into their profile. They may not need to do a comprehensive history and exam again. They could then bill a lower level consult.



Home About Terms Privacy

innoviHealth® - 62 E 300 North, Spanish Fork, UT 84660 - Phone 801-770-4203 (9-5 Mountain)

Copyright © 2000-2024 innoviHealth Systems®, Inc. - CPT® copyright American Medical Association